Timing of discharge post caesarean section and associated reported maternal and perinatal symptoms at Mbagala Rangitatu Hospital.

Abstract

ABSTRACT Background: The decision and time of discharge after caesarean delivery are important to ensure women have optimal recovery. The Tanzania Postnatal Care Guideline recommends that women who had a caesarean section delivery spend the first 72 hours as in-patients for close monitoring. Early discharge is associated with maternal or perinatal re-admission and other complications with a potential for adverse outcomes. To the best of our knowledge, there are no studies on the timing of discharge after caesarean birth and maternal complications in the short term in Tanzania, especially in facilities that have high rates of caesarean section. Aim: This study aims to determine an association between discharge time following caesarean birth and reported short-term maternal and perinatal complications in a high-load urban hospital. Methodology: A cross-sectional study was done from August to November 2023. Women who had been delivered by caesarean section at Mbagala Rangi Tatu and were attending the postnatal clinic on the 7th day were recruited and interviewed. Data was entered, coded and analyzed using the IBM SPSS version 26 computer program. Descriptive statistics were used to describe social demographic and clinical characteristics, and chi-square was used to assess an association between the time of discharge and reported maternal and perinatal symptoms Results: A total of 370 participants were recruited of, 8 (2.2%) and 9 (2.4%) reported having severe maternal symptoms required admission, and severe perinatal symptoms required re admission, respectively. Women who were discharged ≥ 72 hours had a higher proportion of having newborns with severe perinatal symptoms requiring admission (13.0%) compared with those discharged in < 72 hours (1.7%) (p 0.014). Women discharged ≥ 72 hours had a higher proportion of severe reported maternal symptoms required admission (21.7%) compared with those discharged in < 72 hours (0.9%) (p<0.001). Conclusion: Following an uncomplicated caesarean section, a brief hospital stay (less than 72 hours) was not linked to maternal or perinatal readmission or other issues that could have a negative impact. Therefore < 72 hours discharge can be adopted in uncomplicated caesarean section and considered as an alternative to those women who discharged at ≥ 72 hours