title: Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial.
abstract: OBJECTIVE
  To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2.
  
  
  METHODS
  Healthy women admitted for planned cesarean delivery were randomized to day 1 or day 2 discharge. Postoperative assessment for suitability for discharge was based on defined criteria. Primary outcomes were patient satisfaction with their discharge timing assessed at 2 weeks and reported exclusive breastfeeding at 6 weeks after discharge. Analyses were based on intention-to-treat and per-protocol discharge.
  
  
  RESULTS
  Of the 360 women randomized, results of 170 compared with 172 and 142 compared with 148 (day 1 compared with day 2) were available for intention-to-treat and per-protocol analyses, respectively. Nine women fulfilled discharge criteria but declined day 1 discharge, and 12 women allocated to day 2 discharge took their own discharge on day 1. Intention-to-treat analysis showed that satisfaction with discharge protocol was expressed by 148 of 170 (87.1%) compared with 147 of 172 (85.5%) (relative risk 1.1, 95% confidence interval [CI] 0.6-2.1, P=.75) and exclusive breastfeeding (at 6 weeks) was reported by 76 of 170 (44.7%) compared with 77 of 172 (44.9%) (relative risk 1.0 95% CI 0.7-1.5 P=.99 for day 1 compared with day 2 discharges, respectively). All secondary outcomes assessed at up to 6 weeks after discharge including unscheduled maternal or infant medical consultations, rehospitalizations, maternal antibiotic use, and maternal well-being, anxiety, and depression status, were similar. Results on per-protocol analysis were also similar.
  
  
  CONCLUSIONS
  Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes.
  
  
  BACKGROUND
  ISRCTN Register, ISRCTN.org, ISRCTN27523895.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia. pctan@um.edu.my
authors.forename: Peng Chiong
authors.initials: PC
authors.lastname: Tan
authors.forename: Mat Jin
authors.initials: MJ
authors.lastname: Norazilah
authors.forename: Siti Zawiah
authors.initials: SZ
authors.lastname: Omar
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001942:Breast Feeding / Q000523:psychology; D002585:Cesarean Section / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare / Q000523:psychology; D010351:Patient Discharge; D010359:Patient Readmission; D017060:Patient Satisfaction; D011247:Pregnancy; D016896:Treatment Outcome