Volume 26 Issue 6 - May 9, 2014 PDF
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Early Oral Intake and Gastrointestinal Function After Cesarean Delivery: A Systematic Review and Meta-Analysis
Yu-Yun Hsu1,*, Hsiao-Ying Hung2 , Shu-Chen Chang3, Ying-Ju Chang1
1 Associate Professor, Department of Nursing, College of Medicine, National Cheng Kung University
2 Doctoral student, Institute of Allied Health Science, College of Medicine, National Cheng Kung University
3 Nursing Supervisor, Department of Nursing, National Cheng Kung University Hospital
 
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Objective: To evaluate the effects of early oral intake after cesarean delivery on gastrointestinal outcomes during postpartum recovery.

Data Sources: Electronic databases of published studies between 1980 and 2011 were searched, including PubMed, Medline, CINAHL, ClinicalTrials.gov, and Airiti databases

Methods of Study Selection: Randomized controlled trials (RCTs) and nonrandomized trials (non-RCTs) were included. Two reviewers extracted data using a systematic manner and appraised the quality of each study independently. Meta-analyses were conducted only for RCTs using the RevMan5.

Tabulation, Integration, and Results: Seventeen studies met eligible criteria and were retrieved, including 14 RCTs and 3 non-RCTs. Early oral intake was mainly provided within 6 to 8 hours after cesarean delivery. Early oral intake was significantly related to the return of gastrointestinal functions compared with delayed oral intake (bowel sound 9.2 hours; passage of flatus 10 hours; bowel evacuation 14.6 hours). Early oral intake did not significantly augment the occurrence of gastrointestinal complications compared with delayed oral intake after cesarean delivery (ileus symptoms 18.7% compared with 18%, OR 0.98; vomiting 5% compared with 5.5%, OR 0.9; nausea 10.3% compared with 10.3%, OR 1.03; abdominal distention 9.3% compared with 11.6%, OR 0.82; diarrhea 3.4% compared with 5%, OR 0.62).

Conclusion: Early oral intake after cesarean delivery enhances the return of gastrointestinal function and does not augment the occurrence of gastrointestinal complications. A clinical implication based on the findings of the current evidence is suggested.
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