الفهرس 
CESAREAN SECTIONOnly 14 pages are availabe for public view
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Abstract
This study was conducted to evaluate the effect of immediate oral hydration initiated within the first 2 hours after the uncomplicated Caesarean section on the following post-operative outcomes:
1. Post-operative vomiting and abdominal distention.
2. Post-operative nausea and abdominal pain.
3. Return of intestinal movements.
4. Duration of intravenous fluid administration.
5. Duration of hospital stay.
6. Participant satisfaction.
This randomized controlled study was conducted at Ain Shams University Maternity hospital. It included 140 women who underwent uncomplicated Cesarean Section under regional anesthesia, and they were randomly assigned into two groups:
1: group I (Immediate hydration) ”70 women”:
They received oral fluids immediately (within the first 2 hours postoperatively), beginning with water or clear fluids (but not milk or soda containing drinks). The amounts were according to their needs, solid food was given gradually after tolerating the drinks, and intravenous fluids were given besides all of that and till the return of intestinal movements.
2: group E (Early hydration) ”70 women”:
They received the routine intravenous fluids, and the oral fluids were given after 8 hours postoperatively and gradually, solid food was allowed after that gradually too, and the intravenous fluids were stopped after the return of intestinal movements.
Allocation randomization was performed by computer-generated random sequence, and allocation concealment was done by using sealed opaque consecutively numbered envelopes.
Women were excluded if they had medical disorders in the form of HTN, DM, and Hepatic disorders. Also if they had bleeding disorders, intraoperative bowel or bladder injury, intraoperative or immediate postoperative severe bleeding, chronic gastrointestinal problems like chronic constipation, peptic ulcer, oesophagitis, hiatus hernia or irritable bowel syndrome and also if they had severe abdominal adhesions.
The women were subjected to written consent, and they were regularly examined and asked questions by the caregivers to assess the following data: 1: Incidence of Post-operative nausea, vomiting, abdominal distention and abdominal cramps. 2: Time of return of intestinal movements. 3: Timing of discontinuation of intravenous fluids. 4: Duration of hospital stay. 5: Participant psychological satisfaction.
Both groups were matched regarding maternal age, gestational age, parity and indications of Cesarean Section. Our results showed that there were no significant differences between the two groups regarding frequency of nausea, vomiting, abdominal distention and abdominal pain. The same, no significant differences were found between both groups regarding time until return of intestinal movements, time of passage of flatus, time until removal of intravenous fluids, time to initiate breastfeeding, time of hospital discharge and occurrence of postoperative complications like wound infections and paralytic ileus.
Although the differences between the two groups were not significant regarding most of the study results, the immediate oral hydration group showed many results that were relatively better than the early oral hydration group. For example, the time until the return of intestinal sounds, the time until the passage of flatus, the time until disconnection of intravenous fluids and the time to initiate breastfeeding. All these times were shorter in the immediate oral hydration group than the early hydration one. Also, the immediate group showed less frequent nausea, vomiting and abdominal pain than the early oral hydration group.
The only high significant difference between both groups was regarding psychological satisfaction with the p-value < 0.001, most of the women in the immediate hydration group were satisfied with the method of hydration as they were not experiencing the thirst sensation after the operation, and they decided to choose the immediate hydration again in the following deliveries.