Readmission following caesarean section: Reasons for readmission and outcomes for women in one large Irish Maternity hospital

Background Women who birth by caesarean section (CS) are more likely to require readmission to hospital following birth compared to women who birth vaginally. Rates of readmission in a large tertiary hospital were, however,... [ view full abstract ]

Background
Women who birth by caesarean section (CS) are more likely to require readmission to hospital following birth compared to women who birth vaginally. Rates of readmission in a large tertiary hospital were, however, unknown.

Aim
To examine the reasons, management and outcomes for women readmitted to one tertiary maternity hospital following birth by caesarean section.

Objectives
1) To ascertain the number of women readmitted following birth by elective and emergency CS
2) To identify the reasons for readmission following birth by elective and emergency CS
3) To describe the outcomes for women in terms of the investigations performed, medication administered and length of hospital stay

Methods
A retrospective audit of maternity records was conducted in one tertiary maternity hospital for the period 1st August 2014 to 31st July 2015, following approval from the hospital ethics committee.


Findings
In the 12-month period there were 8580 births and, of these, 2470 (28.8%) women gave birth by CS. A total of 107 women (4.3% of the women who gave birth by CS) required readmission to hospital; 46 women (1.9%) were readmitted following elective and 61 (2.5%) following emergency CS. The most common reason for readmission was wound infection with the majority of women requiring analgesics and intravenous antibiotics, and an average hospital stay of 2.64 nights (SD = 2.24) following elective and 4.61 nights (SD = 3.86) following emergency CS.

Conclusion and implications
Documenting the number of women readmitted to hospital postpartum, and the reasons for readmission, can help identify the occurrence of maternal morbidities at different stages of the postnatal period. These findings will make it easier to identify women at risk of postpartum morbidity following birth by CS, and can help healthcare professionals look into better ways of preventing or managing these health problems promptly. This could improve women’s overall health and wellbeing, prevent readmission to hospital and separation from their babies and families, and ultimately, reduce costs to the health service.