Improving Maternal Outcomes After Cesarean Section Through Oral Carbohydrate Supplementation

Abstract

Problem & Purpose: Women scheduled for cesarean sections at a mid-size community hospital are instructed to fast after midnight and approximately 40% of women experience thirst and hunger. However, current literature on enhanced recovery after cesarean recommends maternal consumption of a carbohydrate beverage to improve maternal insulin resistance, decrease postpartum bleeding, alleviate postoperative maternal thirst and hunger, and improve early breastfeeding. The purpose of this quality improvement project was to implement and evaluate compliance with consumption of preoperative carbohydrate beverages, such as Gatorade or Powerade, for women over 18 undergoing an elective cesarean. Methods: Stakeholders within anesthesia and obstetrics departments were identified and mobilized. Education sessions were held for 24 anesthesia providers, eight obstetricians, and 34 labor and delivery staff about project objectives and workflow changes. Eligible participants receiving a scheduled cesarean section were educated by their obstetrician office on volume and time of oral carbohydrate beverage intake. On the day of surgery, anesthesia providers inquired if eligible patients received preoperative education and consumed the beverage as instructed. Data was collected and analyzed weekly into Research Electronic Data Capture software. Results: Over a 15-week implementation period involving 33 participants, 25 surveys were completed. Twenty-two yielded 100% compliance with both obstetrician education and patient consumption, while three yielded 0% compliance with both goals. Overall compliance with preoperative education and participant consumption was 88%. Conclusion: When patients were educated on oral carbohydrate beverages, they were 100% compliant with consumption. Project success and sustainability rely on effective and consistent preoperative education. Early mobilization, targeted education, and minimal workflow changes facilitated project feasibility.