Abstract
INTRODUCTION: Enhanced Recovery After Surgery (ERAS) is a protocol initiated in many specialties with the goal of reducing health care costs, postoperative complications, and patient morbidity. METHODS: We undertook a retrospective cohort study of pregnant women undergoing nonlaboring, nonurgent cesarean delivery between October 2020 and October 2021. Data pertaining to demographic characteristics, pregnancy comorbidities, and maternal and neonatal outcome measures pertaining to operative and postoperative complications, readmission, length of stay, breastfeeding, neonatal cord gases, and neonatal intensive care unit admission were abstracted from electronic health records and compared across two groups, preimplementation and postimplementation, using Student t-test, Pearson’s χ2, Mann-Whitney U, and/or Fisher’s exact test, as indicated. Statistical significance was set at P<.05. Institutional review board approval was obtained. RESULTS: Demographic characteristics and rates of pregnancy comorbidities, including chronic hypertension, hypertensive disorders of pregnancy, and pregestational/gestational diabetes, were similar across pregnant women undergoing cesarean delivery in the preimplementation (N=168) and postimplementation (N=123) groups. Cesarean procedure duration, overall intraoperative and/or postoperative complication rates, readmission, breastfeeding rates, and postoperative length of stay did not change after ERAS implementation and were comparable to the pre-ERAS cohort. Postoperative Foley catheter replacement was more common after ERAS implementation (P=.03). Neonatal outcomes were comparable across both study groups. CONCLUSION: Implementation of an ERAS protocol did not significantly alter maternal and neonatal clinical outcomes in our study cohort with the exception of a small increase in Foley catheter replacement rates, which may be attributable to the protocol workflow requiring Foley removal within 6 hours postoperatively.
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