Building the evidence base for postoperative and postpartum advice.
Recommendations for activity after obstetric and gynecologic procedures remain based on tradition and anecdote. After reviewing the current evidence base, guidelines, and practice for postdischarge instructions related to physical activity after the most common obstetric and gynecologic surgical procedures, we conclude that the available data do not support many of the recommendations currently provided. Restrictions on lifting and climbing stairs should likely be abandoned. Guidance on driving should focus on the concern regarding cognitive function and analgesics rather than concerns of wound separation/dehiscence. Given the impact of these recommendations on daily life events, consistent, evidence-based advice on when and how women can safely resume exercise, driving, working, and sexual intercourse is critical. The evidence base informing advice for most of these issues is minimal; we need prospective, well-designed studies to help guide us and our patients.
Minig
Lucas
L
From the Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Grupo para el estudio de las disfunciones y rehabilitación del piso pélvico, Buenos Aires, Argentina; Obstetrics department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Pregnancy and Perinatology Branch, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, Maryland.
Trimble
Edward L
EL
Sarsotti
Carlos
C
Sebastiani
Mario M
MM
Spong
Catherine Y
CY
D001334:Automobile Driving; D003289:Convalescence; D015444:Exercise; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000534:rehabilitation*; D006801:Humans; D010353:Patient Education as Topic; D011183:Postoperative Complications / Q000517:prevention & control*; D049590:Postpartum Period; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012725:Sexual Behavior