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In women undergoing CD, early oral intake is well tolerated and results in earlier return of bowel function.

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We aim to assess the effect of standardized maternal anesthesia and surgery during pregnancy on the developing fetal brain in a rabbit model. Comparable to humans, the brain growth spurt in rabbits occurs in the perinatal period. STUDY DESIGN: 14 time-mated pregnant does (155 pups) underwent a laparotomy for 1.5h at day 28 of gestation (term¼31d). After induction with propofol, anesthesia was maintained with 4 vol-% sevoflurane for 2h. Maternal vital signs were continuously monitored (blood pressure, heart rate, peripheral and cerebral oxygen saturation, temperature, end-tidal CO 2 , pH, lactate). 7 does (74 pups), underwent invasive hemodynamic monitoring for 2h without sedation (sham). At term, does were delivered by cesarean section. Part of the pups underwent motoric and sensoric neurologic testing followed by euthanasia and brain histology at day 1. Other pups had daily neurodevelopment tests for 2 weeks and an extensive neurologic evaluation at 5 and 7 weeks (open field, object recognition test, T-maze and radial arm maze). RESULTS: Blood gases and vital parameters were stable during anesthesia. On postnatal day 1 surgery pups had significant lower motoric (25.0AE1.1 vs 23.2AE3.6;p¼0.004) and sensoric (16.7AE2.2 vs 15.0AE2.9;p¼0.005) neurobehavioral scores. Surgery pups were equal in weight but had smaller brains hence lower brain to body weight ratio (3.7%AE0.6 vs 3.4% AE0.6 ; p¼0.001). Neuron density was lower in multiple brain regions (e.g. hippocampus 2617AE410 vs 2053AE492 neurons/mm 2 ; p¼0.004) with lower proliferation rates and lower synaptic density. Daily testing showed delayed motoric development, e.g. hopping appearing later (6,4AE5,3 vs 12,3AE3,4 d; p¼0.011). By 7 weeks, no neurobehavioral differences were observed except for a reduced digging behavior (Table). CONCLUSION: In rabbits, 2h maternal general anesthesia and laparotomy without fetal manipulation at d28 of gestation have a measurable impact on the term neonatal neurologic function and brain morphology. Pups develop slower but by 7 weeks, most of the differences faded out to become almost unrecognizable.

Not wearing a WC during postpartum rounds did not affect the patient-physician communication or patient satisfaction scores. In the setting of prior reports showing a risk of WC pathogen transmission between patients, our findings cannot support the routine wearing of WCs during postpartum rounds.