Effect of Early Versus Traditional Hospital Discharge on Maternal Outcome
NCT ID: NCT03475303
Last Updated: 2018-03-23
Study Results
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Basic Information
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UNKNOWN
NA
156 participants
INTERVENTIONAL
2018-03-31
2018-12-31
Brief Summary
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aim of the work is to assess rate of maternal hospital revisits after early hospital discharge at 8-12 hours following elective cesarean delivery compared to the current practice of discharge at 24-48 hours postoperatively.
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Detailed Description
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Randomized clinical trial
Protocol of a thesis for partial fulfillment of master degree in obstetrics and gynecology
Postgraduate Student: Hebatallah Saad Sedky Mohamed Degree: M.B.B.Ch., faculty of medicine- Alexandria university (2013)
Co-DIRECTOR: Prof. Dr. Ahmed Hamdy Nagiub Abdulrahman Academic Position: professor of Obstetrics and Gynecology Department: faculty of medicine- Ain Shams University
Co-DIRECTOR: Dr. Mohamed Esmat Abbas Shawky Academic Position: Lecturer of Obstetrics and Gynecology Department: faculty of medicine- Ain Shams University
What is already known on this subject? What does this study add? The rate of cesarean delivery is increasing, in developing countries, its rate ranges from 13 to 47% of all cases of delivery (Gibbons et al 2010). Current practice is to discharge women from hospital 24-48 hours after cesarean delivery, however in some rural areas there is a common practice of earlier discharge. The effect of earlier discharge on women health is controversial. The present study will investigate the possibility of earlier discharge to reduce the cost of hospitalization and postoperative care, increase the turnover rate of obstetric hospitals and improve maternal outcome.
Many studies were concerned by early discharge of patients as there is evidence for colorectal surgery suggests that enhanced recovery programmes can reduce hospital stays by 0.5-3.5 days compared with conventional care (Fiona Paton et al 2014).
The average hospital stay following Cesarean delivery in most hospitals is 2 to 4 days (Tan et al 2012). Hospitalization allows close monitoring of women and early discovery and management of complication. Early discharge would, therefore, be a disadvantage and may delay identification and treatment of maternal and infant morbidity (National Institute of Health 2011). In contrast, several studies concluded that early discharge after Cesarean delivery is not associated with maternal readmissions (Brown et al 2011) and is associated with more maternal satisfaction and lesser cost (Umbeli et al 2010) and will decrease burden on medical facilities, increase turnover of obstetrics, reduce the cost of postoperative care, reduce rate of hospital acquired complications and Improve maternal neonatal relationship.
Conditions
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Study Design
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NA
SINGLE_GROUP
DIAGNOSTIC
NONE
Study Groups
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early hospital discharge
women will be discharged early from hospital 12 hours postoperatively after elective cesarean sections.
early hospital discharge
early hospital discharge at 8-12 hours for women undergone elective cesarean section
Interventions
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early hospital discharge
early hospital discharge at 8-12 hours for women undergone elective cesarean section
Eligibility Criteria
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Inclusion Criteria
* Gestational age between 37-42 weeks
* BMI less than 30 kg/m2
* Have normal uncomplicated pregnancy
* Planned lower uterine segment Cesarean section
* Planned for primigravida or previous one or two Cesarean sections
* Planned to have spinal anesthesia
* Cesarean sections without intra-operative complications
* Accepting to participate in the study
Exclusion Criteria
* Gestational age less than 37 or more than 42 weeks
* BMI 30 kg/m2 or more.
* Multiple pregnancies
* Polyhydraminos
* Abnormal placenta
* Premature rupture of membranes
* Previous abdominal surgeries or uterine surgeries
* Not more than previous two Cesarean sections
* Anemia: Hemoglobin level less than 10 g/dl
* Cesarean section with intraoperative complications
* General anesthesia
* Fibroid uterus
* RH incompatibility ( as there maybe delay of availability of anti-d immunoglobulins)
* History of complicated pregnancy or delivery
* Medical disorders(hypertension, diabetes mellitus, cardiac, pulmonary, renal, hepatic, endocrine and autoimmune disorders).
* Women refusing participating in the study
* Women having any contraindications or refusing spinal anesthesia
20 Years
35 Years
FEMALE
Yes
Sponsors
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Ain Shams University
OTHER
Responsible Party
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Heba Saad
principle investigator, Ain Shams university
Principal Investigators
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Hebatallah S Sedky, M.B.B.Ch
Role: PRINCIPAL_INVESTIGATOR
Ain Shams University
Locations
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Ainshams maternity hospital
Cairo, EGY 818, Egypt
Ainshams maternity hospital
Cairo, Egy818, Egypt
Countries
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Central Contacts
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Facility Contacts
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References
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Adanikin AI, Orji EO, Fasubaa OB, Onwudiegwu U, Ijarotimi OA, Olaniyan O. The effect of post-cesarean rectal misoprostol on intestinal motility. Int J Gynaecol Obstet. 2012 Nov;119(2):159-62. doi: 10.1016/j.ijgo.2012.05.033. Epub 2012 Aug 25.
Other Identifiers
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Early discharge
Identifier Type: -
Identifier Source: org_study_id
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