Application of enhanced recovery after cesarean delivery. A review

Caesarean section is the most common surgical intervention over the world, so the development of the enhanced recovery after cesarean delivery is turning out to be a vital problem. The practical application of the enhanced recovery after cesarean requires multidisciplinary collaboration and well-coordinated teamwork of an anesthesiologist, an obstetrician-gynecologist, nursing staff and other specialists. In this review, we have studied recent domestic and foreign articles dedicated to the enhanced recovery after cesarean. Particular attention was paid to the case management at all stages of the perioperative period, especially preoperative preparation, postoperative care and womens awareness raising. The presented studies included such program criteria as avoidance of prolonged preoperative fasting accompanied by early postoperative feeding, early breastfeeding attachment of the newborn, the use of multimodal analgesia in the postoperative period, the early activation of the postoperative patient, and the minimization of the detention period of hospital stay. The reviewed articles indicated the positive impact of this program on maternal and newborn outcomes and demonstrated the need for detailed further study of several issues and standardization of the enhanced recovery after cesarean methods.