SECOND AUDIT OF THE IMPROVED REHABILITATION AFTER CAESAREAN SECTION AT THE MOTHER-CHILD COMPLEX AT THE MILITARY HOSPITAL OF ANTSIRANANA.

Abstract

Introduction: The first audit shows the difficulty of implementing early feeding, oral analgesia, removal of the urinary catheter as well as stopping the infusion, with a median duration of 3.5 days. Our objectives are to evaluate adherence to the protocol after the audit and to determine the impact on the stay hard.

METHOD: This is a prospective observational audit study, from February to July 15, 2019, at the Mother-Child Complex of the Antsiranana Military Hospital. Parturients operated for caesarean section under spinal anesthesia, ASA 1 or 2 are included in this study.

Results: Seventy-four patients were retained. Intraoperatively, optimization of vascular filling was performed in 60 patients (81%). All patients received prevention of postoperative nausea / vomiting and intrathecal morphine. In the post-intervention ward, oral analgesia is started within one hour after surgery in all patients (100%). The peripheral venous route is obstructed in 71 cases (96%). The urinary catheter was removed from 71 patients (96%). Seventy-two cases (97%) resumed drinking in unlimited quantities and a light diet at the fourth hour. Two cases (3%) had postoperative nausea and urinary retention requiring an evacuating catheter. The median length of stay of the mother / newborn couple in hospital was 3 (2-3) days. Conclusion: there is an increase in the adhesion of the protocol. It decreases the length of stay of hospitalization.