Effect of initiation time of oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women

Abdominal operations as gynaecological procedures result in gastrointestinal dysmotility. Early feeding and ambulation are nonpharmacologic interventions which can be useful in re-initiation of bowel function. This study was done to evaluate the effect of early oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women. In this randomized clinical trial, 120 primiparous women undergone elective cesarean section were assigned to control and intervention groups in Hajar hospital, Shahrekord, Iran during 2007. In the interventional group, oral hydration with liquids was started 4 hours after surgery regardless of presence of bowel sounds and solid food was started after bowel sounds appeared. The control group recieved liquid diet 12 hours after the operation if it was tolerated, they were given soft diet and regular food at the next meal. The return of bowel activity, time of ambulating, satisfaction, discharge from the hospital and complications were compared in two groups. The data were analyzed using SPSS-15, Chi-Square, T and one way ANOVA tests. The mean postoperative time interval to first hearing of normal intestinal sounds in interventional versus control groups were (9.5±1.38 and 12.5±2.5 hours) the first passage of flatus (15.7±3.61 vs.22.4±4.1 hours), time to first sensation of bowel movement (10.8±1.99 versus 15.7±3.4 hours) and defecation (18.9±3.65 versus 23.4±4.85 hours). These differences were significant (P<0.05). Also discharge from the hospital (0.96±0.18 versus 1.1±34 days) were significantly shorter in interventional group (P<0.05). The women in the early feeding group got out of bed (patient mobilisation) earlier than their interventional group (14.1 hours versus 18.8 hours (P<0.05). Maternal satisfaction was significantly higher among the early fed women (P<0.05). Early oral hydration after elective cesarean section associated with rapid resumption of intestinal motility and increased woman’s satisfaction.