La césarienne : une intervention qui doit maintenant bénéficier du concept de réhabilitation précoce postopératoire

Caesarean delivery, a very common surgical procedure, may be considered as a minor surgical procedure since current surgical techniques are associated with reduced trauma and return to normal life soon after surgery. Postoperative rehabilitation allowing rapid recovery is critical to strengthen mother and newborn relationship in this setting. Improvement in current practices could be achieved by modifying simple but important strategies, i.e.: reducing invasive procedures (limiting time of bladder catheterisation and intravenous infusion in the postpartum); allowing fluid intake immediately in the post-anaesthesia care unit and oral feeding in the first hours after surgery; ensuring that adequate pain control is achieved by using multimodal strategies and patient controlled oral analgesia in order to reduce the use of opioids and their side effects; efficaciously and safely preventing postpartum haemorrhage by the administration of oxytocin, and, whenever possible, carbetocin single injection. These recommendations are simple and easy to implement through clinical pathways that should now be undertaken in every maternity unit.