Returning of Bowel Function in Early Versus Delayed Oral Feeding after Cesarean Delivery

Abstract

Objectives: To study the recovery time of the normal bowel function in early oral feeding patients after the cesarean delivery. Materials and Methods: This randomized controlled trial included 140 term pregnant women who had uncomplicated cesarean delivery under spinal anesthesia at Chonburi Hospital during December 26, 2018 - June 30, 2019. The patients were categorized into two groups: 1) the patients who experienced early oral feeding after 6 hours following the cesarean delivery and 2) the patients who received delayed oral feeding after 12 hours following the cesarean delivery. The sample size of each group was 70 (n = 70), collected via blocked randomization. The main purpose of this categorization was that to compare the time to first passage of flatus and defecation between these two groups. In addition, the postoperative gastrointestinal complications and the patient’s satisfaction level (by Short Assessment of Patient Satisfaction score), which were regarded as the supporting outcomes, were collected. Results: The study found that the mean time to first passage of flatus in early oral feeding group, which was 1,485.29 ± 538.15 minutes (24.7 ± 8.9 hours), was significantly shorter than the delayed feeding group, which was 2,411.29 ± 451.51 minutes (40.1 ± 7.5 hours), at 95 percent confidence level. Besides, the early oral feeding group produced the mean first defecation time of 2,106.71 ± 582.98 minutes (35.1 ± 9.7 hours) after the cesarean delivery, which was significantly shorter than the mean first defecation time of 3,295 ± 553.89 minutes (54.9 ± 9.2 hours) yielded by the delayed feeding group at 95 percent confidence level. Additionally, the patient’s satisfaction level in the early oral feeding group was higher than the other group; however, the more signs of nausea and vomiting symptoms were shown in the early feeding group. Conclusion: The returning of the normal bowel function after the cesarean section in term pregnant women under spinal anesthesia can be improved by starting the oral feeding after 6 hours following the cesarean section. However, the chance for undergoing the nausea and vomiting symptoms tends to be higher in patients who received the early feeding practice.

Keywords

• cesarean delivery
• early oral feeding
• gastrointestinal complication