OBJECTIVE: To study the rate of ileus symptoms and hospital course of women
who are offered solid food shortly after cesarean delivery.
METHODS: This study involved women delivered by cesarean under regional ane
sthesia, Exclusion criteria included general anesthesia, magnesium sulfate,
intra-operative bowel injury or bowel surgery, or other conditions that pr
ecluded early feeding. Early-fed women were offered regular diets within 8
hours of surgery, and controls were given nothing by mouth for 12-24 hours,
advanced to clear liquids on the first postoperative day, and then given s
olid food on the second or third postoperative day.
RESULTS: Sixty women were assigned randomly to each method, Early-fed women
received solid food sooner after surgery, 5.0 +/- 1.2 hours versus 40.0 +/
- 10.6 hours. The incidences of mild ileus symptoms and postoperative compl
ications were similar in both groups; however, the study did not have an ad
equate sample size to definitively assess safety concerns, Women in the ear
ly-fed group had shorter hospital stays (49.5 +/- 12.7 hours versus 75.0 +/
- 12.3 hours, P < .001), and shorter time intervals from surgery to bowel m
ovement, 34.5 hours (interquartile range 25.3-48.8) versus 51.0 (43.3-62.0)
hours, P < .001. In the early-fed group, women whose operative times excee
ded 40 minutes were more likely to have symptoms of mild ileus,
CONCLUSION: Early initiation of solid food after cesarean delivery appears
to be well tolerated and may be associated with a shorter hospital stay, Ea
rly-fed women whose operations exceed 40 minutes may be more likely to have
mild ileus symptoms. (C) 2001 by the American College of Obstetricians and
Gynecologists.