Comparing the outcome of patients discharged in early postoperative period, with patients discharged at late postoperative period in a tertiary care hospital

Abstract

Background: It has become common practice to discharge women from hospital early after caesarean section, to satisfy their wishes or to reduce workload the objectives of this study were to determine women’s satisfaction, and rates of wound infection, maternal readmission, and early postnatal depression. Postnatal hospital stay has two main objectives; the first, to identify any complication for both mother and newborn and the second, to provide the necessary support to the new mother for her return home. The two main reasons for this change in the service provided are to improve women’s satisfaction during this period and to reduce the cost to the health system.

Methods: Retrospective study from January 2016 to January 2017 in a tertiary care hospital. Patient underwent Lower Section Caesarean Section (LSCS) were grouped into 2 groups. Group I- patients discharged on 5^th post-operative day (POD). Group II-patient discharged at 8^th POD. 500 patients were included in each group. Patient discharged on 5^th POD was instructed about the warning symptoms of puerperium about fever, breast engorgement, wound discharge, foul smelling vaginal discharge, and advised for suture removal in nearby health facility.

Results: Those who discharged at 5^th POD (500) were followed through phone at 10th POD and only 498 could be traced and complications and satisfaction was made in discharge proforma. Of 500 patients discharge at 5th POD only 498 responded to phone call. Wound infection was found in 2 patients of those 2, both were asked to attend the post- natal clinic and found to have mild wound induration with minimal wound discharge which responded well to oral anti biotic and daily dressing in nearby health facility.

Conclusions: In developing countries like India 70% of the patients undergo delivery in government hospitals. Most of them were belong to low socio-economic status and they have to go to daily work for their daily needs. If a patient is admitted for a prolonged period in a hospital the helping members who come to hospital, have to stay along with the patients and they will lose their daily income which will create debt to the family which in turn causes economic burden and psychological stress. This will reflect on the post-natal nutrition to the mother and baby.