Early maternal feeding following cesarean delivery: A prospective randomized study

Abstract

RANDOMIZED STUDY GUY BAR, EYAL SHEINER, ADI LEZEROVIZT, TAL LAZER, MORDECHAI HALLAK, Soroka University Medical Center, Ben Gurion University of theNegev,Departments ofObstetrics andGynecology,Beer-Sheva, Israel OBJECTIVE: To evaluate the effect of early maternal feeding (i.e. eating and drinking) on gastrointestinal function and maternal satisfaction in patients following simple and complicated cesarean delivery (CD). STUDY DESIGN: A prospective, randomized study was designed including 179 women undergoing first or repeated cesarean delivery. Patients were assigned randomly by picking one opaque sealed envelope in order to receive the assignment. Women who were assigned to the early feeding group received clear fluids and solid food immediately after the operation, and up to 8 hours following the procedure, according to their request. The traditionally fed women have received clear fluids 8-12 hour after the surgery subsequent to physician examination confirming bowel sounds. RESULTS: Eighty-two women were assigned to the traditionally feeding group, and 97 to the early feeding group. From the patients undergoing randomization, 58.7% had a repeated CD, and 27.9% had abdominal adhesions necessitating adhesiolysis. No significant differences were noted between the groups regarding post-operative complications, such as ileus and wound infection (3.1% in the early feeding vs. 8.5% in the traditional feeding group; P=0.114). Maternal satisfaction, however, was significantly higher among the early fed women (94.4% vs. 78.4% in the traditional feeding group; P=0.008). Most patients from the early feeding group tended to recommend such policy (95.8%), as compared to only 56.0% in the traditional feeding group (P=0.001). Using a multivariable analysis with post-operative complications as the outcome variable, controlling for operation number, no association was found between early feeding and post operative complications at the ward (OR=0.9; 95%CI 0.1-7.9; P=0.949). CONCLUSION: Early maternal feeding following cesarean delivery is not associated with higher rates of post-operative complications. Yet, it is associated with higher maternal satisfaction.