Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial.

Abstract:

OBJECTIVES:To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2. METHODS:Healthy women admitted for planned cesarean delivery were randomized to day 1 or day 2 discharge. Postoperative assessment for suitability for discharge was based on defined criteria. Primary outcomes were patient satisfaction with their discharge timing assessed at 2 weeks and reported exclusive breastfeeding at 6 weeks after discharge. Analyses were based on intention-to-treat and per-protocol discharge. RESULTS:Of the 360 women randomized, results of 170 compared with 172 and 142 compared with 148 (day 1 compared with day 2) were available for intention-to-treat and per-protocol analyses, respectively. Nine women fulfilled discharge criteria but declined day 1 discharge, and 12 women allocated to day 2 discharge took their own discharge on day 1. Intention-to-treat analysis showed that satisfaction with discharge protocol was expressed by 148 of 170 (87.1%) compared with 147 of 172 (85.5%) (relative risk 1.1, 95% confidence interval [CI] 0.6-2.1, P=.75) and exclusive breastfeeding (at 6 weeks) was reported by 76 of 170 (44.7%) compared with 77 of 172 (44.9%) (relative risk 1.0 95% CI 0.7-1.5 P=.99 for day 1 compared with day 2 discharges, respectively). All secondary outcomes assessed at up to 6 weeks after discharge including unscheduled maternal or infant medical consultations, rehospitalizations, maternal antibiotic use, and maternal well-being, anxiety, and depression status, were similar. Results on per-protocol analysis were also similar. CONCLUSION:Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes. CLINICAL TRIAL REGISTRATION:ISRCTN Register, ISRCTN.org, ISRCTN27523895.

journal_name

Obstet Gynecol

authors

Tan PC,Norazilah MJ,Omar SZ

doi

10.1097/aog.0b013e3182723a95

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1273-82

issue

6

eissn

0029-7844

issn

1873-233X

pii

00006250-201212000-00005

journal_volume

120

pub_type

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