Effectiveness of Enhanced Recovery After Cesarean Section Protocols Compared with Conventional Care: A Systematic Review
Efectividad de las guías de recuperación mejorada tras la cesárea frente a la atención convencional: Revisión sistemática
DOI:
https://doi.org/10.22258/hgh.v10i2.392Abstract
Objective: To evaluate the effectiveness of Enhanced Recovery After Cesarean (ERAC) guidelines compared to conventional care, analyzing their impact on key postoperative maternal outcomes, including hospital stay, pain control, opioid use, early mobilization, initiation of breastfeeding, and complication rate. Methodology: A systematic literature review was conducted following the PRISMA guidelines. The protocol was registered in PROSPERO (CRD420251061931). A search was performed in the Medline and Scopus databases for observational studies and clinical trials published in English between 2020 and June 2025. Women over 18 years of age who underwent cesarean section were included, while reviews, editorials, and pregnancies with major complications were excluded. Methodological quality and risk of bias were assessed using the National Heart, Lung, and Blood Institute tool. Results: Thirty studies were included. Most studies presented a moderate risk of bias. The implementation of ERAC protocols was consistently associated with a reduction in hospital stay, lower opioid consumption, better pain control, fewer hours of preoperative fasting, early mobilization, early removal of urinary catheters, and prevention of hypothermia. No increase in complications or hospital readmissions was observed. Furthermore, several studies reported greater maternal satisfaction and support for early initiation of breastfeeding. Conclusion: ERAC protocols are a safe and effective strategy that improves maternal recovery, optimizes resources, and does not increase adverse events. Their implementation, adapted to the local context, represents a viable alternative to conventional care and could be considered for implementation in obstetric practice. Keywords: Enhanced Recovery After Surgery; Perioperative Care; Cesarean Section (Source: MeSH, NLM).Downloads
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