Enhanced Recovery Protocol After Cesarean Section

Summary

This study aims to evaluate the effectiveness of implementing the Enhanced Recovery After Cesarean (ERAC) protocol on maternal and neonatal outcomes.

Research hypotheses

To fulfill the aim of the study, the following research hypotheses are formulated:

Hypothesis I: Women who receive the ERAC protocol experience faster recovery compared to those who receive routine hospital nursing care.

Hypothesis II: Women who receive the ERAC protocol experience fewer maternal and neonatal complications than those who receive routine hospital nursing care.

Conditions

• Cesarean Section

Interventions

PROCEDURE

Enhanced Recovery after Cesarean protocol of Care

• The intervention group will receive the Enhanced Recovery after Cesarean protocol of Care which consists of: Preoperative Care: * Patient education covering the procedure, perioperative expectations, pain management plan, early oral intake and mobilization goals, discharge criteria, and follow-up schedule. * Minimizing fasting: Solid food allowed up to 6 hours and clear fluids up to 2 hours prior to surgery. * Carbohydrate loading: Administration of 45g non-particulate carbohydrate drink up to 2 hours before surgery for non-diabetic mothers. Intraoperative Care: * Antibiotic prophylaxis: Administered within 60 minutes prior to skin incision. * Thermal regulation: Use of active warming methods, warmed IV fluids, and maintaining operating room temperature \>72.8°F (22.7°C). * Anesthesia: Neuraxial anesthesia with hypotension prevention strategies (fluid preloading/co-loading and phenylephrine infusion). * Delayed cord clamping: For 30-60 seconds after birth. * Immediate maternal-newborn

PROCEDURE

Routine hospital care

The control group will receive routine preoperative, intraoperative, and postoperative nursing care according to standard hospital practice. Preoperative care: • Fasting from both food and fluids for at least 8 hours before surgery. Intraoperative care: • Immediate umbilical cord clamping after birth. Postoperative care: * Analgesia according to routine hospital practice without a standardized multimodal analgesic regimen. * Urinary catheter removal at least 12 hours after surgery.

Sponsors & Collaborators

• Mansoura University

  lead OTHER

Principal Investigators

• Noura G El-Gamel, MSc · Mansoura University

• Enas S Fathy · Mansoura University

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

35 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-02-01

Primary Completion

2025-09-30

Completion

2025-10-30

Countries

• Egypt

Study Locations