Enhanced Recovery After Surgery Protocols in Cesarean Delivery in International Settings: A Clinical Review of Implementation in Turkey and Croatia
Surgeries (Switzerland), vol.6, no.1, 2025 (ESCI, Scopus)
- Publication Type: Article / Article
- Volume: 6 Issue: 1
- Publication Date: 2025
- Doi Number: 10.3390/surgeries6010016
- Journal Name: Surgeries (Switzerland)
- Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Directory of Open Access Journals
- Keywords: cesarean section, enhanced recovery after surgery, healthcare systems, perioperative care
- Yozgat Bozok University Affiliated: Yes
Abstract
Background: Enhanced Recovery After Surgery (ERAS) protocols have become integral in improving postoperative outcomes in cesarean deliveries. Variations in protocol adherence and implementation practices can significantly impact maternal and neonatal health across different healthcare systems. Objective: To evaluate the implementation of ERAS protocols in cesarean deliveries across two countries—Croatia and Turkey—and highlight differences in the level of adherence to ERAS recommendations. Design: A comparative clinical review was conducted. The study employed qualitative assessments carried out by medical professionals at two hospitals: one in central Anatolia, Turkey, and the Clinical Hospital “Sveti Duh” in Zagreb, Croatia. Methods: Twenty perioperative ERAS recommendations were evaluated based on implementation levels, rated using a five-point Likert scale (from very low to very high implementation). Qualitative insights were also collected to understand challenges and adaptations in the implementation process. Results: In Croatia, 13 recommendations were implemented at a very high level, compared to 8 in Turkey. Conclusions: Croatia demonstrates higher and more consistent adherence to ERAS protocols compared to Turkey, which faces greater challenges in consistent implementation, particularly in preoperative and postoperative care.