Abstract

A comparative study of early versus delayed (conventional) oral feeding after caesarean delivery

Background: To evaluate the effect of early oral feeding versus delayed after uncomplicated caesarean section, under regional anaesthesia on women’s satisfaction and post operation outcome as per ERASS (Enhanced Recovery After Surgery Society) recommendations (Part-3) given in 2019. The study was undertaken at a tertiary care hospital MV Jayaram medical college and research hospital Bangalore, India; between 2020-2021. It was a prospective observational study. All healthy pregnant women undergoing caesarean delivery were selected and informed about ERASS protocol, out of which those with uncomplicated singleton pregnancy undergoing caesarean under spinal anaesthesia were allocated into two groups EF (Early Feeding: after 2 hours) and DF (Delayed feeding: 18-24 hours) and initiated oral feeding.

Maternal satisfaction was studied as primary outcome and gastro intestinal function (i.e. Return of bowel sounds, passage of flatus and stool), mobilization and any complications in post-operative period as secondary outcome.

Results: Out of 626 women admitted to our hospital for delivery, 148 women undergoing C-section were randomized into delayed feeding (n=78) and early feeding (n=70). Maternal satisfaction was almost similar in both the groups DF=80%; EF=98.57%. High statistical difference was noted in EF group for return of bowel sounds 4.71± 1.83 hours vs. 13.72 ± 3.08 hours; passage of flatus 9.89 ± 3.00 hours vs. 13.72 ± 3.08 hours and ambulation 9.57± 1.62 vs. 14.95 ± 3.9 hours.

Conclusion: ERASS strategy is safe, approach to post-operative care in clinical practice in those undergoing caesarean delivery. Though our observations on maternal satisfaction were equivalent but our variables on secondary outcome were highly significant without any adverse gastro intestinal complications.

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