Optimising recovery after caesarean delivery

IF 4.7 3区医学 Q1 ANESTHESIOLOGY Best Practice & Research-Clinical Anaesthesiology Pub Date : 2024-09-01 DOI:10.1016/j.bpa.2024.10.003

Sarah Ciechanowicz , Evy De Greef , Marc Van de Velde , Pervez Sultan

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Abstract

Caesarean delivery is the most performed inpatient surgery worldwide, with rates expected to rise. Optimising maternal recovery benefits not only the mother, but also the newborn and society. Enhanced Recovery After Caesarean delivery (ERAC) protocols standardize the approach to perioperative management of patients in order to accelerate early postoperative maternal rehabilitation. Implementation of ERAC protocols has been associated with improved maternal and neonatal outcomes including shorter hospital stay, lower pain scores and opioid consumption, fewer complications, higher maternal satisfaction, and greater breastfeeding success. Higher-quality evidence is needed to support and evaluate ERAC protocols as they continue to be refined with the application of regional analgesia and an individualized approach to pain management. Recent work has described the postpartum period as a complex multidimensional process. A holistic approach to measuring postpartum recovery could provide valuable insights for tailoring interventions and supporting services to promote maternal recovery after caesarean delivery.

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