Evidence-based cesarean delivery: preoperative management (part 7)

Area of Science:

• Obstetrics and Gynecology
• Surgical Patient Care

Background:

• Cesarean delivery requires standardized preoperative protocols to minimize maternal and neonatal morbidity and mortality.
• Existing practices vary, necessitating evidence-based guidelines for optimal patient outcomes.

Purpose of the Study:

• To review and synthesize current evidence on preoperative interventions for cesarean delivery.
• To provide evidence-based recommendations for hospital protocols to improve patient safety and outcomes.

Main Methods:

• Systematic review of interventions related to preoperative cesarean delivery preparation.
• Analysis of studies focusing on infection rates, pain management, hemorrhage, thromboembolism, and intraoperative complications.

Main Results:

• Recommendations include preoperative showering, avoiding hair removal by shaving, no enemas, and clear liquid/light meal intake guidelines.
• Specific antibiotic prophylaxis (cefazolin, azithromycin), tranexamic acid, and venous thromboembolism prophylaxis are advised.
• Patient positioning (left lateral tilt), nonadhesive drapes, and surgical safety checklists are recommended; routine cell salvage and maternal supplemental oxygen are not.

Conclusions:

• Standardized preoperative protocols for cesarean delivery are crucial for reducing adverse outcomes.
• Implementing evidence-based practices in preoperative preparation can significantly enhance maternal and neonatal safety.