Introduction and objectives: Early initiation of oral feeding after caesarean delivery is well-tolerated by patients, but is not yet practiced in most institutions. This study evaluated the safety and efficacy of early initiation of oral feeding in postcaesarean patients, compared with delayed feeding. Materials and methods: The study was conducted in the department of obstetrics and Gynecology of Guru Teg Bahadur Hospital, Delhi, India, from July 1, 2008 to Oct 31, 2008. Two hundred (200) consecutive women undergoing uncomplicated caesarean section under regional anesthesia were included. They were divided into two groups: patients in group A (n = 100) were allowed sips of water orally within 6 hours postsurgery, followed by gradual dietary expansion; patients in group B (n = 100) were allowed oral sips after return of bowel sounds. Demographic, intraoperative, and postoperative outcomes were recorded and analyzed. Results: Demographic and intraoperative observations were comparable in both groups. Women in group A had earlier return of bowel sounds, compared to women in group B (7.8 ± 1.4 hours and 14.7 ± 2.1 hours, respectively; p < 0.001). Women in group A passed stools earlier, compared to women in group B (42.3 ± 6.7 hours and 69.4 ± 7.3 hours, respectively; p < 0.001). Hospital stays were shorter in group A, compared to group B (59 ± 7.3 and 88 ± 9.5, hours, respectively; p < 0.001). The presence of nausea, vomiting, and abdominal distension was comparable in both groups. Mean satisfaction score was much higher in the early fed group than in the later-fed group (89.6 ± 6.1 versus 49.7 ± 7.5). Conclusions: Early oral intake following uncomplicated caesarean section under regional anesthesia is safe and well-tolerated; produces a better outcome, compared to delayed feeding, without causing any significant increase in postoperative morbidity, including paralytic ileus; and results in higher patient satisfaction. (J GYNECOL SURG 26:247)
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References
1.
WorthingtonLM, MulcalryAJ. Attitudes to oral feeding following caesarean section. Anesthesia, 1999; 54:292.
2.
ChantarasornV, TannirandornY. A comparative study of early post operative feeding vs conventional feeding for patient undergoing caesarean section: A randomized controlled trial. J Med Assoc Thai, 2006; 89,suppl4:511.
3.
KovavisarachE, AttrakornM. Early vs delayed oral feeding after caesarean delivery. Int J Gynaecol Obstet, 2005; 90:31.
4.
GocmenA, GocemenM, SaraogluM. Early postoperative feeding after caesarean delivery. J Int Med Res, 2002; 30:506.
5.
MulayimB, CelikN. Early oral hydration after caesarean delivery performed under regional anesthesia. Int J Gynecol Obstet, 2008; 101:273.
6.
OrjiEO, OlabodTO. A randomised trial of early initiation of oral feeding after caesarean section. J Maternal Neonatal Med, 2009; 22:65.
7.
BinderowSR, CohenSM, WexnerSD. Must early postoperative oral intake be limited to laproscopy?Dis Colon Rectum, 1994; 37:584.
Patolia DolarS, Hilliard RoberLM. Early feeding after caesarean section: Randomised trial. Obstet Gynecol, 2001; 98:113.
10.
SorianoD, DulitzkiM, KeiderN. Early oral feeding after caesarean delivery. Obstet Gynecol, 1996; 87:1006.
11.
IzbizkyGH, SebastianiMA. The effect of early vs delayed post caesarean feeding on women's satisfaction—a randomized control trial. Obstet Gynecol Survey, 2008; 63:351.
KramerRL, Van SomerenJK. Postoperative management of caesarean patient—the effect of immediate feeding on incidence of ileus. Obstet Gynecol, 1996; 88:29.
14.
BenhamouD, TecsyM, PanyN. Audit of an early feeding program after caesarean delivery: Patient wellbeing is increased. Canadian J Anesthesia, 2002; 49:814.
15.
BurrowWR, GingoAJ. Safety and efficacy of early postoperative solid food consumption after caesarean section. J Reprod Med, 1995; 40:463.
16.
AdupaD, WadabwaJ, KiondoP. A randomized controlled trial of early initiation of oral feeding after caesarean delivery in Mulago Hospital. East African Med J, 2003; 80:345.
