Cesarean Section, Gum Chewing, Gut Motility
Conditions
Brief summary
Many women deliver by caesarean section nowadays. The proportion of women who deliver by caesarean section ranges from 15% to over 50%, in some countries. After a caesarean section it is common for the bowel to stop working for several hours or days. Although this usually resolves by itself in a few days, it may be very uncomfortable. The retained gases and stools can cause the mother's belly to become swollen and painful with cramps and she may feel nauseated and vomit so she is not able to eat. She may need additional medications to ease these symptoms and her hospital discharge may be delayed. The use of medications that relieve pain during labour and painkillers following the surgery can also delay bowel function. Small intestine activity after abdominal operations returns to normal function within a few hours, gastric activity returns to normal within 24-48 hours, and colon activity returns to normal within 48-72 hours. Due to the delayed motility of the gastrointestinal system in the postoperative period, gas and secretions accumulate in the stomach and small and large intestines, which causes abdominal distension, nausea, vomiting, and pain, all of which negatively affect the comfort level of the patients. Chewing sugar-free gum after cesarean section can promote the early recovery of gastrointestinal function, but the side effects of chewing gum are still unclear, which needs more clinical, large sample and high-quality studies to further verify.
Interventions
DIETARY_SUPPLEMENTSugar free chew gum
Chew gum has a role in ERAS protocol which is significant in early post operative recovery as compared to normal routine care methods
OTHERNil Per Oral
According to classic protocols patient were kept nil per oral till bowel sounds were audible
Sponsors
CMH Gujranwala
Dr Maryam Aslam
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Females of age 18-40 years * Parity \<5 * Presenting at gestational age ≥ 37 weeks, * Undergoing cesarean section (as per operational definition) under spinal anesthesia
Exclusion criteria
* Females with history of chronic constipation (medical record) * Females with obstructed labour, hypothyroidism (TSH\>5IU) * Females with intra operative complications such as bowel injury, history of gastrointestinal surgery, and water and electrolyte disturbances (on medical record), abnormal placenta (accrete, increta, previa, abruption)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Time of Passage of First flatus | 06 Months | In group A, females were given chewing gum 6 hours after the surgery, three times a day till passage of flatus. In group B, females were managed as per standard routine protocol i.e. allowing oral when bowel sounds are audible. Mean time of passage of first flatus since procedure was noted in terms of hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Duration of Hospital Stay | 06 Months | In both groups mean duration of hospital stay was noted in terms number of days required to stay in the hospital after cesarean. Patients were discharged once they were pain free and on oral medication. |
Countries
Pakistan
Outcome results
None listed