Masood Shabeen N, Masood Yasir, Naim Uzma, Masood Muhammad F
Sobhraj Maternity Hospital, Karachi Metropolitan Corporation, Karachi, Pakistan.
Department of Surgery, Ziauddin Medical University, Karachi, Pakistan.
Int J Gynaecol Obstet. 2014 Aug;126(2):115-9. doi: 10.1016/j.ijgo.2014.02.023. Epub 2014 Apr 29.
To compare the effects of two maternal feeding policies-early versus conventional oral feeding-after cesarean delivery.
This prospective multicenter randomized comparative trial was conducted at tertiary care hospitals in Sindh, Pakistan, from 2010 to 2012. Women with an uncomplicated cesarean delivery under spinal anesthesia were allocated to an intervention of early (after 2 hours) or conventional (after 18 hours) initiation of oral feeding. Outcomes included maternal ambulation, maternal satisfaction, gastrointestinal functions, and length of hospital stay.
In total, 1174 women (n=587 per group) were included in the final analysis. Gastrointestinal complications were not significantly different between the two groups. Lower intensities of thirst and hunger and a higher rate of maternal satisfaction were observed in the early feeding group (P<0.05), and 53.8% of women in this group were able to ambulate within 15 hours of surgery, compared with 27.9% of women in the conventional feeding group. The frequencies of readmission, febrile morbidity, and wound infection were insignificant.
Early oral dietary initiation after cesarean delivery resulted in early ambulation, greater maternal satisfaction, and reduced length of hospital stay, with no detrimental outcomes, making this practice cost-effective. Hence, day-care cesarean delivery might be an option in resource-constrained settings.
ChiCTR-TRC-13003651, http://www.chictr.org.
比较剖宫产术后两种产妇喂养策略——早期与传统经口喂养——的效果。
这项前瞻性多中心随机对照试验于2010年至2012年在巴基斯坦信德省的三级医疗机构开展。接受脊髓麻醉且剖宫产过程顺利的女性被分配至早期（术后2小时）或传统（术后18小时）开始经口喂养的干预组。观察指标包括产妇下床活动情况、产妇满意度、胃肠功能及住院时长。
最终分析纳入了总共1174名女性（每组587名）。两组的胃肠道并发症无显著差异。早期喂养组的口渴和饥饿程度较低，产妇满意度较高（P<0.05），该组53.8%的女性在术后15小时内能够下床活动，而传统喂养组这一比例为27.9%。再次入院、发热性疾病及伤口感染的发生率无统计学意义。
剖宫产术后早期经口进食可使产妇早日下床活动，提高产妇满意度，并缩短住院时长，且无不良后果，这一做法具有成本效益。因此，在资源有限的环境中，日间剖宫产可能是一种选择。
ChiCTR-TRC-13003651，http://www.chictr.org 。
