The effect of preoperative oral carbohydrate on the time to colostrum and amount of vaginal bleeding after elective cesarean section

Abstract

Objective: To investigate the effect of oral carbohydrate at 2 h before elective cesarean section on postoperative recovery indicators such as the time to colostrum and vaginal bleeding. Methods: Women undergoing elective cesarean section under spinal-epidural anesthesia, aged 20-40 years, with a body mass index (BMI) of 19-30 kg/m 2 and an American Society of Anesthesiology (ASA) score of II were randomized to the oral carbohydrate group (the OC group), the oral placebo group (the OP group), or the control group (the C group). The OC group underwent oral carbohydrate preloading (300 mL/bottle), the OP group orally consumed 300 mL of distilled water, and the C group was forbidden from drinking or eating on the day of the operation. The time to colostrum, vaginal bleeding, time to exhaust, and complications were recorded. Results: A total of 38 participants in the OC group, 37 in the OP group, and 37 in the C group completed the study. Compared with the OP group and the C group, the OC group produced colostrum significantly earlier, had a lower amount of 24-h vaginal bleeding, and had a higher 24-h consumption of analgesics. Compared with OP and OC groups, the C group took longer to exhaust. No significant intergroup difference was observed for any other indicator. Conclusion: Oral carbohydrates loading 2 h before elective cesarean section significantly reduces the time to produce colostrum and the amount of vaginal bleeding, which contributes to postoperative recovery.

Effects of Preoperative Oral Carbohydrate on Perioperative Maternal Outcomes Undergoing Cesarean Section: A Systematic Review and Meta-Analysis

“…Outcomes included thirst and hunger scores, incidence of vomiting and nausea, time to flatus, and insulin resistance. One study [ 18 ] was administered under general anesthesia, and the other eight [ 15 – 17 , 19 – 23 ] were administered under spinal anesthesia.…”

“…Three [ 15 , 19 , 21 ] studies involving a total of 319 patients were conducted to compare the incidence of vomiting between the CHO and control groups. The pooled result of these studies revealed that CHO did not have a significant impact on the incidence of vomiting compared to water (RR = 0.70; 95% CI: 0.28 to 1.77) or fasting (RR = 0.46; 95% CI: 0.20 to 1.09).…”

“…Three studies [ 15 , 19 , 22 ] involving 286 patients compared the time to return of flatus after cesarean section between the CHO and control groups. The pooled result indicated that CHO did not significantly alter the time to flatus compared to water (WMD: −2.84 hours, 95% CI: −9.26 to 3.58).…”

“…Two studies [ 15 , 17 ] involving 203 patients reported the time to colostrum in CHO groups and controls. One study [ 17 ] reported the time to colostrum after surgery was significantly shorter in the CHO group than in the water group (27.47 ± 11.51 vs. 51.96 ± 20.20 min, p < 0.001).…”

“…One study [ 17 ] reported the time to colostrum after surgery was significantly shorter in the CHO group than in the water group (27.47 ± 11.51 vs. 51.96 ± 20.20 min, p < 0.001). Another study [ 15 ] reported that the time to colostrum was significantly shorter in the CHO group than in the water or fasting group (20.4 ± 13.7 vs. 39.8 ± 18.8 or 41.3 ± 17.6 h, respectively, p < 0.001).…”