ERAS for Cesarean Delivery: RCT Meta-Analysis Findings

A meta-analysis of randomized controlled trials comparing ERAS pathways in cesarean delivery with conventional postoperative care reported pooled estimates consistent with faster recovery and lower pain and costs after cesarean birth.

The review synthesized 10 randomized controlled trials enrolling 1,934 participants and compared ERAS protocols with standard care after elective or emergency cesarean section. Across recovery, pain, and resource-use outcomes, pooled analyses were reported as favoring ERAS over conventional care. The meta-analysis described shorter postoperative length of stay, lower hospitalization costs, and faster return of gastrointestinal function based on time to first flatus and time to first stool. It also reported lower postoperative visual analog scale pain scores, and the pooled data included a reduction in postpartum hemorrhage volume.

For maternal and neonatal safety outcomes, pooled analyses did not show statistically significant differences between ERAS and conventional care for several endpoints. Reported measures included postoperative nausea and vomiting, urinary retention, postoperative infection, deep venous thrombosis, and 30-day readmission, as well as NICU admission among neonatal outcomes.

The authors advised caution in interpretation given the limited number of included trials and variation in protocol content across studies.