الفهرس 
Title : The Effect of Post Cesarean Section Protocol of Care on Early and Follow up Outcomes
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Abstract
Background: The rate of caesarean section has been increased dramatically over the past 3
decades. Mothers undergoing caesarean section need more care and attention than mothers
undergoing normal vaginal delivery and the time needed for recovery of post cesarean section
women is more than those needed for vaginal delivery. Aim: Is to evaluate the effect of post
cesarean section protocol of care on early and follow up outcomes. Design: randomized controlled
trial (Parallel group design). Methods: Random sample of 150 mothers were randomly allocated
into three groups; two intervention groups and one control group, 50 for each group. Mothers who
underwent cesarean birth were randomly assigned to 3 groups by using permuted blocks of
different sizes (3, 6, and 9), depending on the use of two different methods of chewing gum and
early oral hydration, with early mobilization. Only standard of care was applied to the mothers in
the control group. Three tools were utilized for data collection; structured interviewing
questionnaire schedule, post cesarean section early assessment sheet and post cesarean section
follow up assessment sheet. Results: The intestinal sounds were heard earlier, time of passing
flatus was earlier, and the intestinal movements were earlier in the oral fluid group as compared to
the other two groups (P < 0.05). Seventy percent of mothers in the oral fluid group passed flatus
at 6 hrs as compared to 62% of mothers in the chewing gum group and 4% of mothers in the control
group with statistical significant differences between the two intervention groups and the control
group (P< 0.001). Further, mothers in the oral fluid group had shorter hospital stay duration than
mothers in the chewing gum group and mothers in the control group as a primary outcome. In
relation to follow up outcomes; as wound infection in the three groups, findings revealed no
statistical difference between the three groups. Chewing gum shows the best outcome in relation
to wound infection and hospital readmission. Conclusion: Fluid intake and chewing gum besides
early ambulation as a protocol of care for mothers who had cesarean section may had a better
maternal outcome manifested as early resumption of intestinal movements, passing flatus and short
hospital stay.