Frijmersum Zayël Z, Van der Meij Eva, Bouwsma Esther V A, Verhoeven Corine J M, Anema Johannes R, Huirne Judith A F, Bakker Petra C A M
Department of Obstetrics and Gynaecology, Research Institute, Amsterdam University Medical Center location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands (Frijmersum and Huirne).
Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands (Frijmersum).
AJOG Glob Rep. 2024 Oct 28;4(4):100411. doi: 10.1016/j.xagr.2024.100411. eCollection 2024 Nov.
Evidence suggests that postpartum recovery takes longer than 6 weeks. However, evidence-based recommendations regarding postpartum recovery are lacking. Current research mainly focuses on shortening hospital stay after childbirth, neglecting outpatient recovery.
This study aimed to develop multidisciplinary recommendations on convalescence after vaginal and cesarean delivery using a modified Delphi method to improve recovery after childbirth.
Multidisciplinary experts employed in different medical organizations involved in care and guidance of patients during postpartum recovery participated in the study. The panel included 16 experts (5 gynecologists, 2 senior residents, 4 midwives, 2 maternity nurses, 2 general practitioners, and 1 pelvic floor physical therapist) and representatives from medical organizations. Detailed recommendations on convalescence after uncomplicated vaginal delivery and uncomplicated cesarean delivery were developed. In addition, a list with 35 potential affecting factors that could delay recovery was presented to identify circumstances in which the convalescence recommendation should be adapted. Recommendations were based on a literature review and a modified Delphi procedure among 16 experts. Multidisciplinary consensus of at least 67% was achieved on convalescence recommendations for 27 relevant functional activities after childbirth.
Multidisciplinary consensus on convalescence recommendations was reached for 26 of 27 functional activities for uncomplicated vaginal and cesarean delivery after 6 Delphi rounds and 2 group discussions. In total, 7 out of 32 affecting factors were deemed as independent factors that may delay recovery and therefore change the convalescence recommendations. The recommendations were deemed feasible by representatives from the same medical organizations as the panel.
Multidisciplinary consensus on recommendations regarding convalescence after uncomplicated vaginal delivery and uncomplicated cesarean delivery was achieved.
有证据表明产后恢复时间超过6周。然而，缺乏关于产后恢复的循证建议。目前的研究主要集中在缩短产后住院时间，而忽视了门诊恢复情况。
本研究旨在采用改良德尔菲法制定关于阴道分娩和剖宫产术后康复的多学科建议，以改善产后恢复情况。
参与产后恢复期间患者护理和指导的不同医疗组织的多学科专家参与了该研究。该小组包括16名专家（5名妇科医生、2名高级住院医师、4名助产士、2名产科护士、2名全科医生和1名盆底物理治疗师）以及医疗组织的代表。制定了关于无并发症阴道分娩和无并发症剖宫产术后康复的详细建议。此外，还列出了35个可能延迟恢复的潜在影响因素清单，以确定应调整康复建议的情况。建议基于文献综述和16名专家之间的改良德尔菲程序。在产后27项相关功能活动的康复建议上达成了至少67%的多学科共识。
经过6轮德尔菲法和2次小组讨论，在无并发症阴道分娩和剖宫产术后27项功能活动中的26项康复建议上达成了多学科共识。在32个影响因素中，共有7个被视为可能延迟恢复并因此改变康复建议的独立因素。该建议被与专家小组来自同一医疗组织的代表认为是可行的。
在无并发症阴道分娩和无并发症剖宫产术后康复建议方面达成了多学科共识。
