559: Walking to a better future? Post-operative ambulation after cesarean delivery and the correlation to complications.


      There is a favorable effect of postoperative ambulation on the reduction of surgical complications. However, little is known about maternal mobility following a cesarean delivery. The goal of this study was to assess the correlation between post-partum maternal mobility following a cesarean delivery and post-operative morbidity.

      Study Design

      A prospective study was conducted in a tertiary hospital in patients after a cesarean delivery. We recruited them after the sergury and prior to ambulation. An accelerometer (Polar A300 fitness watch & activity tracker) was given to each participent. Routine instructions for mobilization were given and the patients were asked to wear the accelerometer consistently. The accelerometer was collected at the end of the hospitalization. Computerized files and discharge letters were reviewed and patients’ outcomes were analyzed. The Mann-Whitney U test was used for comparison of groups and ROC curve for threshold number of steps.


      Data were analyzed for 197 patients. 107 (54.4%) of the cesarean deliveries were urgent and 90 (45.6%) were elective. Mean age was 33.06±6.0 years, mean BMI was 27.56±6.0 kg/m2. The median number of steps per hour was 94.3 for post-operative day 0 (POD 0), 109.4 for POD1, 149.8 for POD2 and 155.7 for POD3. The median number of steps per hour was higher for multiparous compared to nulliparous (p-value 0.035). A trend for higher risk for complications with lower mean steps per day was observed for each day of hospitalization (Figure 1). A threshold of more than 640 steps is associated with reduced complications.


      There is a clear trend between the extent of ambulation after cesarean delivery and post-operative complications.
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