Early compared with delayed oral fluids and food after caesarean section

Cochrane Review by Mangesi L, Hofmeyr GJ

This record should be cited as: Mangesi L, Hofmeyr GJ. Early compared with delayed oral fluids and food after caesarean section. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD003516. DOI: 10.1002/14651858.CD003516.

ABSTRACT

Title

Early compared with delayed oral fluids and food after caesarean section

Background

It is customary for fluids and/or food to be withheld for a period of time after abdominal operations. After caesarean section, practices vary considerably. These discrepancies raise concern as to the bases of different practices.

Objectives

To assess the effect of early versus delayed introduction of fluids and/or food after caesarean section.

Search strategy

We searched the Cochrane Pregnancy and Childbirth Group trials register (January 2002) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001).

Selection criteria

Clinical trials with random allocation comparing early versus delayed oral fluids and/or food after caesarean section were considered. The participants were women within the first 24 hours after caesarean section. The criteria for 'early' feeding were as defined by the individual trial authors - usually within six to eight hours of surgery.

Data collection and analysis

Trials considered were evaluated for methodological quality and appropriateness for inclusion. For dichotomous data, relative risks and 95% confidence intervals were calculated. Continuous data were compared using weighted mean difference and 95% confidence interval. Sub-group analyses were performed for general anaesthesia, regional analgesia and where anaesthesia was mixed or undefined.

Main results

Of 12 studies considered, six were included in this review. Four were excluded and two are pending further information. The methodological quality of the studies was variable. Only one to three studies contributed usable data to each outcome. Three studies were limited to surgery under regional analgesia, while three included both regional analgesia and general anaesthesia.

Authors' conclusions

There was no evidence from the limited randomised trials reviewed, to justify a policy of withholding oral fluids after uncomplicatedcaesarean section. Further research is justified.

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