Is there a difference in the maternal and neonatal outcomes between patients discharged after 24 h versus 72 h following cesarean section? A prospective randomized observational study on 2998 patients

Abstract

Objective: To compare the incidence of postpartum maternal and neonatal complications and hospital readmission in patients discharged 24 versus 72 h after cesarean section.

Methods: Using randomization, 1495 patients were discharged after 24 h and 1503 patients were discharged after 72 h. All patients fulfilled the discharge criteria. Patients were assessed 6 weeks after delivery, any maternal or neonatal problems or hospital readmissions during this time interval were reported.

Results: There was no difference in maternal hospital readmission between the two groups, but there was a significantly higher neonatal readmission rate in the 24-h group mainly due to neonatal jaundice. As for the complications reported after 6 weeks, the only two significant outcomes were initiating breast feeding, being significantly higher in the 72-h group [OR and 95% CI 0.77 (0.66-0.89)] and the mood swings being significantly lower in the 72-h group [OR and 95% CI 2.28 (1.94-2.68)].

Conclusion: Our recommendation is still in favor of late discharge, after cesarean delivery. Bearing in mind, that an early 24-h discharge, after cesarean delivery is feasible, but with special care of the neonate, with early visit to the pediatrician and early establishment of effective lactation.

Keywords: Cesarean section discharge; hospital readmission; maternal outcome; neonatal outcome; postpartum complications.