Application of Rapid Rehabilitation Concept in Enhanced Recovery After Cesarean Section in Patients With Gestational Diabetes Mellitus: a Systematic Review

Abstract Background: Gestational diabetes mellitus (GDM) is defined as all cases of diabetes observed during gestation, including pre-gestational diabetes and true GDM with its first onset during pregnancy. A rising number of parturient are diagnosed with GDM due to increased maternal weight, creating a serious global health concern. In order to improve maternal health and reduce childhood mortality, rapid rehabilitation approaches for postpartum recovery are of significant importance. However, most guidelines regarding this area remains extremely limited with poor quality, Methods: All the references included in this work were either in English or in Chinese, enrolled via systematic selection from database PubMed, Web of Science (WOS) and CNKI. “Gestational diabetes mellitus”, “rehabilitation”, “cesarean”, “neonatal diabetes mellitus” etc. were selected as keywords during the search. No restriction was placed on publish date, quality or the setting of the studies. Results: A total of 666 literatures were found in the initial selection. After sorting out 130 duplications, 536 articles had titles and abstracts read, among which 70 were thoroughly read. The contents of the articles include maternal-neonatal complications of GDM, maternal health managements in antenatal period, during labor and postpartum period, providing descriptions of maternal and neonatal outcomes after GDM patients receiving the interventions. Conclusions: The application of rapid rehabilitation concept in enhanced recovery of cesarean section in pregnant women with GDM during perioperative period can significantly reduce the risk of multiple maternal-neonatal complications. However, the studies focusing on the discovery of new rapid rehabilitation approaches are still inadequate.