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esarean section (CS) is one of most common major surgical procedures, life-saving both for the mother and the newborn when medically indicated.
This represents a considerable healthcare issue, as it has a significant impact Traditionally, patients are not given fluids or food after abdominal surgery until bowel function returns, as evidenced by bowel sounds, passage of flatus or stool, or a feeling of hunger.
Following abdominal surgery, activity in small intestines starts within 2–3 hours and function is completely recovered within 6–12 hrs. Stomach function returns 12–24 hours after surgery with the large intestines recovering fully between 48–72 hrs. Bowel sound (examined by a physician), passing flatus, and bowel movement, provide clinicians with key indicators to gauge the return of bowel function. Factors influencing these metrics include the size of the incision, the surgical site, operative time, blood loss, type of anesthesia, opioids, general health of the patient, nutrition, and psychiatric condition.
The main purpose of the traditional dietary regimen is to prevent the occurrence of ileus after an abdominal surgery. Recently, early oral intake has been recommended instead of the traditional dietary regimen for women after cesarean delivery. Concerns have been raised about the effect of early oral intake on postoperative ileus and other complications after cesarean delivery.
In this study, we aimed to compare the safety of early (2-4 hrs. postoperative) versus delayed (intestinal sound audible within 6 hours) oral feeding after uncomplicated cesarean section (CS) under spinal anesthesia.
This randomized controlled clinical trial was conducted at tertiary care hospital at Ain Shams University Maternity Hospital from June 2021 till March 2022 and performed on a total of 150 pregnant women who delivered by elective CS under spinal anesthesia.
The current study revealed that there were no statistically significant differences between the studied groups regarding age, gestational age and parity.
The current study results revealed that Time to ambulation, intestinal sound, passing flatus and passing stool statistically were significantly shorter among early feeding group.
Consequently, rate of ambulation and stool passing statistically were significantly higher among early feeding group.
As regards postoperative complications, the current study results revealed that Nausea, vomiting and abdominal distension were non-significantly more frequent among early feeding group, the differences were statistically significant only in abdominal distension. Paralytic ileus not recorded in either group.
Ultimately, the current study results revealed that Patients’ satisfaction was significantly better among early feeding group.
We concluded that early feeding after uncomplicated cesarean section had reduced the rate of ileus symptoms, mean time interval to bowel movement with improvements in return of bowel function and maternal satisfaction, coupled with a lack of gastrointestinal complications and support the advisability of early oral feeding over late oral feeding.
Consequently, the current study results are promising which inspire us to get out of the conventional approach of feeding.
We recommend oral intake within the first 4 hour after cesarean section as a part of standard care for women who undergo cesarean section.