Pub Date : 2025-11-01Epub Date: 2025-07-22DOI: 10.1016/j.ijoa.2025.104737
S Cantellow, Ł Balcerzak, A Schyns-van den Berg, D Dabrowska, E Guasch, H Jörnvall, N Lucas, F J Mercier, C F Weiniger, P Krawczyk
Background: Obstetric critical care patients face unique challenges during intensive care unit (ICU) admission, including separation from their newborns and psychological trauma. The ICU environment, primarily designed to support physiological recovery, may not be optimised for maternal experience. Healthcare staff caring for these patients may also experience psychological distress. This is the third report from the MaCriCare study, which examines maternal experiences, follow-up practices, and staff support provisions in ICUs managing obstetric patients across WHO Europe countries.
Methods: Between September 1st 2021 and January 1st 2022, a multicentre international survey was conducted and included questions on mother-baby contact, breastfeeding support, single-room availability, psychological screening and follow-up, and psychological support for staff in ICUs serving obstetric units. Data from 928 ICUs were analysed.
Results: Physical contact was facilitated in 64.9% (n=602) of centres, while breastfeeding support was available in 82.2% (n=763). Single-room accommodation was accessible in 50%. Psychological screening for obstetric patients and follow-up were conducted in 30.6% (n=284) and 33.1% (n=307) of centres, respectively. In 61.7% (n=573) of ICUs, psychological support for staff was available following poor maternal outcomes.
Conclusion: While breastfeeding support and some form of mother-baby contact were quite widely available, psychological screening, follow-up, and staff support after poor maternal outcomes remained inconsistent. National-level service mapping is needed to identify best practices and context-specific barriers. The impact of bundled interventions to improve maternal experience during critical illness, and staff support strategies after adverse maternal outcomes, should be formally evaluated in future research.
{"title":"Maternal experience in the intensive care unit and post-discharge care: the third report from the MaCriCare study.","authors":"S Cantellow, Ł Balcerzak, A Schyns-van den Berg, D Dabrowska, E Guasch, H Jörnvall, N Lucas, F J Mercier, C F Weiniger, P Krawczyk","doi":"10.1016/j.ijoa.2025.104737","DOIUrl":"10.1016/j.ijoa.2025.104737","url":null,"abstract":"<p><strong>Background: </strong>Obstetric critical care patients face unique challenges during intensive care unit (ICU) admission, including separation from their newborns and psychological trauma. The ICU environment, primarily designed to support physiological recovery, may not be optimised for maternal experience. Healthcare staff caring for these patients may also experience psychological distress. This is the third report from the MaCriCare study, which examines maternal experiences, follow-up practices, and staff support provisions in ICUs managing obstetric patients across WHO Europe countries.</p><p><strong>Methods: </strong>Between September 1<sup>st</sup> 2021 and January 1<sup>st</sup> 2022, a multicentre international survey was conducted and included questions on mother-baby contact, breastfeeding support, single-room availability, psychological screening and follow-up, and psychological support for staff in ICUs serving obstetric units. Data from 928 ICUs were analysed.</p><p><strong>Results: </strong>Physical contact was facilitated in 64.9% (n=602) of centres, while breastfeeding support was available in 82.2% (n=763). Single-room accommodation was accessible in 50%. Psychological screening for obstetric patients and follow-up were conducted in 30.6% (n=284) and 33.1% (n=307) of centres, respectively. In 61.7% (n=573) of ICUs, psychological support for staff was available following poor maternal outcomes.</p><p><strong>Conclusion: </strong>While breastfeeding support and some form of mother-baby contact were quite widely available, psychological screening, follow-up, and staff support after poor maternal outcomes remained inconsistent. National-level service mapping is needed to identify best practices and context-specific barriers. The impact of bundled interventions to improve maternal experience during critical illness, and staff support strategies after adverse maternal outcomes, should be formally evaluated in future research.</p>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104737"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-30DOI: 10.1016/j.ijoa.2025.104714
C Sebastian, R A Gabriel, A Sykes, C Cha, B N Burton
{"title":"Exploring natural language processing as a tool to improve in obstetric documentation and care.","authors":"C Sebastian, R A Gabriel, A Sykes, C Cha, B N Burton","doi":"10.1016/j.ijoa.2025.104714","DOIUrl":"10.1016/j.ijoa.2025.104714","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104714"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-06DOI: 10.1016/j.ijoa.2025.104747
A Weiss, A Ioscovich, M Heesen, A Frenkel, D Shatalin, Y Gozal, S Orbach-Zinger, Y Binyamin
Background: Unintended dural puncture is a recognized complication of neuraxial labor analgesia and has been associated with postdural puncture headache (PDPH). While short-term outcomes are well documented, long-term consequences remain poorly characterized. No previous study has reported follow-up beyond two years.
Methods: This prospective case-control study followed 336 women up to five years after delivery. The cohort comprised 113 women who delivered without labor epidural analgesia, 113 women who delivered with uncomplicated labor epidural analgesia, 54 women with PDPH following an unintended dural puncture who were not treated with an epidural blood patch, and 56 women with PDPH following an unintended dural puncture who were treated with an epidural blood patch. Outcomes included the prevalence of chronic headache and backache assessed through standardized telephone questionnaires based on International Classification of Headache Disorders criteria, as well as functional impact over time evaluated using the Von Korff chronic pain grade questionnaire.
Results: At five years, chronic headache was significantly more common in the two PDPH groups (20.4% with an epidural blood patch and 21.4% without) than in the control groups (5.3% with an uncomplicated epidural procedure and 0.9% without labor epidural; P <0.01). Chronic backache showed a similar pattern (20.8% and 16.1% vs. 5.3% and 0.9%, respectively; P <0.01). Most women reported persistent rather than resolving symptoms. Functional impairment increased over time, with high disability reported in 7 of 16 women (43.8%) with PDPH without an epidural blood patch and 4 of 14 women (28.6%) with PDPH with an epidural blood patch, who reported chronic pain at five years.
Conclusions: This five-years follow-up study demonstrates that chronic pain (headache and backache) after an unintended dural puncture is a prolonged condition with substantial functional consequences, challenging its traditional characterization as a transient complication and underscoring the need for long-term follow-up and prevention.
{"title":"Chronic pain and long-term disability following postdural puncture headache in obstetric patients: a five-year prospective follow-up of a case-control cohort.","authors":"A Weiss, A Ioscovich, M Heesen, A Frenkel, D Shatalin, Y Gozal, S Orbach-Zinger, Y Binyamin","doi":"10.1016/j.ijoa.2025.104747","DOIUrl":"10.1016/j.ijoa.2025.104747","url":null,"abstract":"<p><strong>Background: </strong>Unintended dural puncture is a recognized complication of neuraxial labor analgesia and has been associated with postdural puncture headache (PDPH). While short-term outcomes are well documented, long-term consequences remain poorly characterized. No previous study has reported follow-up beyond two years.</p><p><strong>Methods: </strong>This prospective case-control study followed 336 women up to five years after delivery. The cohort comprised 113 women who delivered without labor epidural analgesia, 113 women who delivered with uncomplicated labor epidural analgesia, 54 women with PDPH following an unintended dural puncture who were not treated with an epidural blood patch, and 56 women with PDPH following an unintended dural puncture who were treated with an epidural blood patch. Outcomes included the prevalence of chronic headache and backache assessed through standardized telephone questionnaires based on International Classification of Headache Disorders criteria, as well as functional impact over time evaluated using the Von Korff chronic pain grade questionnaire.</p><p><strong>Results: </strong>At five years, chronic headache was significantly more common in the two PDPH groups (20.4% with an epidural blood patch and 21.4% without) than in the control groups (5.3% with an uncomplicated epidural procedure and 0.9% without labor epidural; P <0.01). Chronic backache showed a similar pattern (20.8% and 16.1% vs. 5.3% and 0.9%, respectively; P <0.01). Most women reported persistent rather than resolving symptoms. Functional impairment increased over time, with high disability reported in 7 of 16 women (43.8%) with PDPH without an epidural blood patch and 4 of 14 women (28.6%) with PDPH with an epidural blood patch, who reported chronic pain at five years.</p><p><strong>Conclusions: </strong>This five-years follow-up study demonstrates that chronic pain (headache and backache) after an unintended dural puncture is a prolonged condition with substantial functional consequences, challenging its traditional characterization as a transient complication and underscoring the need for long-term follow-up and prevention.</p>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104747"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-06DOI: 10.1016/j.ijoa.2025.104746
K Brosnan
{"title":"Letter to the Editor: Mothers' experiences of category 1 caesarean delivery under general anaesthesia with the partner present: a prospective explorative study.","authors":"K Brosnan","doi":"10.1016/j.ijoa.2025.104746","DOIUrl":"10.1016/j.ijoa.2025.104746","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104746"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.ijoa.2025.104814
J. Guglielminotti , R. Landau , M. Russell , G. Li
Background
Diversification of the healthcare workforce is promoted to address racial and ethnic disparities in obstetric anesthesia care; however, the supporting evidence remains insufficient. We assessed the association of the nurse workforce diversity with neuraxial labor analgesia (NLA) use and disparities in NLA use.
Methods
We analyzed 2019–2022 US birth certificate data for vaginal and intrapartum cesarean deliveries. The exposure was the registered nurse (RN) diversity index in the hospital county, calculated as the proportion of RNs identifying with minoritized racial and ethnic groups divided by the proportion of the county’s total population identifying with those groups. The index was categorized into quartiles with the first quartile indicating the lowest diversity. The outcome was NLA use. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of NLA associated with the diversity index were estimated using mixed-effects logistic regression models.
Results
We analyzed 10,979,988 birth certificates. Overall, 80.0% recorded NLA use. Relative to women who gave birth in hospitals in the first quartile of the RN diversity index (low diversity), the odds of receiving NLA increased 10% for women in the fourth quartile (high diversity) of the index (aOR: 1.10; 95% CI: 1.06, 1.14). Compared with White women, increased odds of receiving NLA associated with higher RN workforce diversity were more pronounced among Hispanic, Black, Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander women.
Conclusions
RN workforce diversity was positively associated with NLA use and reduced disparities in NLA use.
{"title":"Nurse workforce diversity and use of neuraxial labor analgesia in the United States","authors":"J. Guglielminotti , R. Landau , M. Russell , G. Li","doi":"10.1016/j.ijoa.2025.104814","DOIUrl":"10.1016/j.ijoa.2025.104814","url":null,"abstract":"<div><h3>Background</h3><div>Diversification of the healthcare workforce is promoted to address racial and ethnic disparities in obstetric anesthesia care; however, the supporting evidence remains insufficient. We assessed the association of the nurse workforce diversity with neuraxial labor analgesia (NLA) use and disparities in NLA use.</div></div><div><h3>Methods</h3><div>We analyzed 2019–2022 US birth certificate data for vaginal and intrapartum cesarean deliveries. The exposure was the registered nurse (RN) diversity index in the hospital county, calculated as the proportion of RNs identifying with minoritized racial and ethnic groups divided by the proportion of the county’s total population identifying with those groups. The index was categorized into quartiles with the first quartile indicating the lowest diversity. The outcome was NLA use. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of NLA associated with the diversity index were estimated using mixed-effects logistic regression models.</div></div><div><h3>Results</h3><div>We analyzed 10,979,988 birth certificates. Overall, 80.0% recorded NLA use. Relative to women who gave birth in hospitals in the first quartile of the RN diversity index (low diversity), the odds of receiving NLA increased 10% for women in the fourth quartile (high diversity) of the index (aOR: 1.10; 95% CI: 1.06, 1.14). Compared with White women, increased odds of receiving NLA associated with higher RN workforce diversity were more pronounced among Hispanic, Black, Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander women.</div></div><div><h3>Conclusions</h3><div>RN workforce diversity was positively associated with NLA use and reduced disparities in NLA use.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104814"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-07-17DOI: 10.1016/j.ijoa.2025.104730
I Ibrahim Hulchafo, J K Scroggins, S E Harkins, H Moen, M Tadiello, K Cato, A Davoudi, D Goffman, J J Aubey, C Green, M Topaz, V Barcelona
{"title":"In Response to \"Exploring natural language processing as a tool to improve in obstetric documentation and care.\"","authors":"I Ibrahim Hulchafo, J K Scroggins, S E Harkins, H Moen, M Tadiello, K Cato, A Davoudi, D Goffman, J J Aubey, C Green, M Topaz, V Barcelona","doi":"10.1016/j.ijoa.2025.104730","DOIUrl":"10.1016/j.ijoa.2025.104730","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104730"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-06-23DOI: 10.1016/j.ijoa.2025.104710
Anne-Sophie Bouthors, Maxence Hureau, Alexander Butwick
{"title":"[Article traduit] L’administration prophylactique d’acide tranexamique chez toutes les femmes enceintes est-elle efficace pour prévenir la survenue d’une hémorragie post-partum? très probablement non.","authors":"Anne-Sophie Bouthors, Maxence Hureau, Alexander Butwick","doi":"10.1016/j.ijoa.2025.104710","DOIUrl":"10.1016/j.ijoa.2025.104710","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104710"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.ijoa.2025.104804
T. Culling , D. Camilleri , C. Bertorelli , A. Strang , S. Oram , F. Faggian , S. Sharma , A. Ridgway , S. Zaher , M. Labeta , S.A. Jones , L.C. Davies , J. Watkins , K. Siddall , V. Keeping , K. Simpson , M. Bray , P. Ghazal , S.F. Bell , R.E. Collis
{"title":"Response to correspondence from McCarthy et al. regarding maternal sepsis screening and the role of the neutrophil-to-lymphocyte ratio","authors":"T. Culling , D. Camilleri , C. Bertorelli , A. Strang , S. Oram , F. Faggian , S. Sharma , A. Ridgway , S. Zaher , M. Labeta , S.A. Jones , L.C. Davies , J. Watkins , K. Siddall , V. Keeping , K. Simpson , M. Bray , P. Ghazal , S.F. Bell , R.E. Collis","doi":"10.1016/j.ijoa.2025.104804","DOIUrl":"10.1016/j.ijoa.2025.104804","url":null,"abstract":"","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104804"},"PeriodicalIF":2.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.ijoa.2025.104811
P. Sultan , G. Nelson , K. Joudi , D.J. Singh , K.D. Gregory , M. Zakowski , B. Carvalho , Study Investigators
Background
Existing enhanced recovery after cesarean delivery (ERAC) professional society recommendations lack intersociety collaboration, endorsement from relevant US professional societies, and inclusion of patient stakeholders. This initiative aimed to formulate a multidisciplinary set of ERAC interventions supported/endorsed or developed with input from relevant US professional societies, the Enhanced Recovery After Surgery (ERAS) Society and patient representatives.
Methods
This initiative received IRB approval from Stanford University. In total 19 stakeholders were invited to participate in this Delphi study, including 12 from seven US professional societies (American Society of Anesthesiologists (ASA − 1 stakeholder), Society for Obstetric Anesthesia and Perinatology (SOAP − 2), American College of Obstetricians and Gynecologists (ACOG − 4), Society for Maternal Fetal Medicine (SMFM − 1), Society of OBGYN Hospitalists (SOGH − 1), Association of Women’s Health Obstetric and Neonatal Nurses ((AWHONN −2), American Association of Nurse Anesthesiology (AANA − 1), a representative from the ERAS Society, a physical therapist, a lactation expert and 4 patient representatives from diverse backgrounds. A three-round modified Delphi approach was conducted (two rounds of electronic questionnaires and a third round of e-discussion), to produce the final set of ERAC recommendations. An initial list of 70 interventions was compiled based on a previously published systematic review of ERAC studies and professional society guidelines/recommendations (ERAS Society, SOAP, and Healthcare Canada). Consensus was obtained for the final list of interventions, with strong consensus defined as ≥70 % agreement and weak consensus as 50–69 % agreement.
Results
Content-expert stakeholders were included from seven major US professional obstetric, anesthesia and nursing societies, the ERAS Society and physical therapy, lactation consultant and patient representatives also participated. All 19 stakeholders completed each round of the Delphi process. A final set of 32 interventions (six preoperative, 13 intraoperative and 13 postoperative) achieved strong consensus.
Conclusions
This multidisciplinary Delphi study resulted in 32 ERAC interventions, which were supported/endorsed or developed with input from seven US professional societies, the ERAS Society and physical therapy, lactation consultant and patient representatives. These interventions should be considered for patients undergoing scheduled cesarean delivery in the US. Future initiatives are needed to formulate recommendations for non-US and lower resource settings.
{"title":"Professional society recommended interventions for enhanced recovery after cesarean delivery in the United States: a multidisciplinary Delphi study","authors":"P. Sultan , G. Nelson , K. Joudi , D.J. Singh , K.D. Gregory , M. Zakowski , B. Carvalho , Study Investigators","doi":"10.1016/j.ijoa.2025.104811","DOIUrl":"10.1016/j.ijoa.2025.104811","url":null,"abstract":"<div><h3>Background</h3><div>Existing enhanced recovery after cesarean delivery (ERAC) professional society recommendations lack intersociety collaboration, endorsement from relevant US professional societies, and inclusion of patient stakeholders.<!--> <!-->This initiative aimed to formulate a multidisciplinary set of ERAC interventions supported/endorsed or developed with input from relevant US professional societies, the Enhanced Recovery After Surgery (ERAS) Society and patient representatives.</div></div><div><h3>Methods</h3><div>This initiative received IRB approval from Stanford University. In total 19 stakeholders were invited to participate in this Delphi study, including 12 from seven US professional societies (American Society of Anesthesiologists (ASA − 1 stakeholder), Society for Obstetric Anesthesia and Perinatology (SOAP − 2), American College of Obstetricians and Gynecologists (ACOG − 4), Society for Maternal Fetal Medicine (SMFM − 1), Society of OBGYN Hospitalists (SOGH − 1), Association of Women’s Health Obstetric and Neonatal Nurses ((AWHONN −2), American Association of Nurse Anesthesiology (AANA − 1), a representative from the ERAS Society, a physical therapist, a lactation expert and 4 patient representatives from diverse backgrounds. A three-round<!--> <!-->modified Delphi approach was conducted (two rounds of electronic questionnaires and a third round of e-discussion), to produce the final set of ERAC recommendations. An initial list of 70 interventions was compiled based on a previously published systematic review<!--> <!-->of ERAC studies<!--> <!-->and professional society guidelines/recommendations (ERAS Society, SOAP, and Healthcare Canada). Consensus was obtained for the final list of interventions, with strong consensus defined as ≥70 % agreement and weak consensus as 50–69 % agreement.</div></div><div><h3>Results</h3><div>Content-expert stakeholders were included from seven major US professional obstetric, anesthesia and nursing societies, the ERAS Society and physical therapy, lactation consultant and patient representatives also participated. All 19 stakeholders completed each round of the Delphi process. A final set of 32 interventions (six preoperative, 13 intraoperative and 13 postoperative) achieved strong consensus.</div></div><div><h3>Conclusions</h3><div>This multidisciplinary Delphi study resulted in 32 ERAC interventions, which were supported/endorsed or developed with input from seven US professional societies, the ERAS Society and physical therapy, lactation consultant and patient representatives. These interventions should be considered for patients undergoing scheduled cesarean delivery in the US. Future initiatives are needed to formulate recommendations for non-US and lower resource settings.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104811"},"PeriodicalIF":2.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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