الفهرس | Only 14 pages are availabe for public view |
Abstract Background: The rate of caesarean section has been increased dramatically over the past 3 decades. Mothers undergoing caesarean section need more care and attention than mothers undergoing normal vaginal delivery and the time needed for recovery of post cesarean section women is more than those needed for vaginal delivery. Aim: Is to evaluate the effect of post cesarean section protocol of care on early and follow up outcomes. Design: randomized controlled trial (Parallel group design). Methods: Random sample of 150 mothers were randomly allocated into three groups; two intervention groups and one control group, 50 for each group. Mothers who underwent cesarean birth were randomly assigned to 3 groups by using permuted blocks of different sizes (3, 6, and 9), depending on the use of two different methods of chewing gum and early oral hydration, with early mobilization. Only standard of care was applied to the mothers in the control group. Three tools were utilized for data collection; structured interviewing questionnaire schedule, post cesarean section early assessment sheet and post cesarean section follow up assessment sheet. Results: The intestinal sounds were heard earlier, time of passing flatus was earlier, and the intestinal movements were earlier in the oral fluid group as compared to the other two groups (P < 0.05). Seventy percent of mothers in the oral fluid group passed flatus at 6 hrs as compared to 62% of mothers in the chewing gum group and 4% of mothers in the control group with statistical significant differences between the two intervention groups and the control group (P< 0.001). Further, mothers in the oral fluid group had shorter hospital stay duration than mothers in the chewing gum group and mothers in the control group as a primary outcome. In relation to follow up outcomes; as wound infection in the three groups, findings revealed no statistical difference between the three groups. Chewing gum shows the best outcome in relation to wound infection and hospital readmission. Conclusion: Fluid intake and chewing gum besides early ambulation as a protocol of care for mothers who had cesarean section may had a better maternal outcome manifested as early resumption of intestinal movements, passing flatus and short hospital stay. |