Intra-operative instillation of steroids injections (Dexamethasone) during caesarean section to reduce early and late post-operative morbidity

Dexamethasone to Reduce Morbidity in Caesarean Section

Abstract

Objective: To evaluate whether intra-operative intra-peritoneal instillation of dexamethasone reduces immediate and late post-operative morbidity following caesarean section.

Study Type: Interventional comparative study

Place and Duration of Study: Tertiary care hospital in Pakistan from 12 January 2020 to 22 December 2022.

Patients & Methods: A total of 400 women undergoing elective caesarean section were recruited, divided equally into four categories: primigravida and those with 1, 2, or 3 previous caesarean sections. Within each group, 50 patients received intra-peritoneal dexamethasone (3 ml), and 50 served as controls. Post-operative pain was assessed at 6–12 hours, 12–24 hours, and on the first post-operative day. Early mobilization, oral intake, and overall well-being were also recorded. A subgroup of 41 women returning for repeat caesarean section one year later were evaluated for intra-operative adhesions.

Results: Patients who received dexamethasone reported fewer pain complaints and required less additional analgesia compared with controls. On the first post-operative day, additional pain relief was needed in 30–40% of controls versus 12–16% of those receiving dexamethasone. Early mobilization was achieved by 66–76% of the dexamethasone group versus 36–44% of controls. Oral intake and overall well-being were also better in the dexamethasone group. At follow-up, more patients in the intervention group were comfortable at home, and fewer adhesions were noted in women who had received dexamethasone during prior surgery.

Conclusion: Intra-peritoneal instillation of dexamethasone during caesarean section is associated with reduced post-operative pain, earlier recovery, and less morbidity.