Early oral hydration: a novel regimen for management after elective cesarean section.
OBJECTIVE
To compare early oral hydration versus the conventional intravenous fluid replacement after elective cesarean section.


METHODS
Two hundred women performed elective cesarean section were selected and randomized to: Regimen I (n = 100): early oral hydration (sips of fruit juices sweetened with honey once the women felt thirst immediately after the operation, then solid food 24 hours later, the amounts of juice or food were determined by the patient herself, i.e. she would regulate her physiological needs) versus regimen II (n = 100): conventional intravenous hydration (2-3 L of dextrose saline/24 hours and solid food thereafter). Biochemical, metabolic values, postoperative nausea and vomiting, propulsive bowel movements, tolerance of solid food, hospital stay and successful continuation of breast feeding were compared in both groups.


RESULTS
The two regimens were equally effective in maintaining fluid balance and normal plasma and urinary electrolytes without any observed differences in biochemical or metabolic values. The return of bowel sounds, first occurrence of flatus and tolerance of solid food were achieved in regimen I at time periods significantly shorter than those attained with regimen II (p < 0.0001). The incidence of nausea and vomiting, ileus and deep vein thrombosis was higher in regimen II than in regimen I but the difference is statistically insignificant (p > 0.05). Patients in regimen II were hospitalized for significantly longer times than those on regimen I (p < 0.0001). Successful continuation of breast feeding was significantly more in regimen I than in regimen II (p < 0.01).


CONCLUSIONS
Early oral hydration after elective cesarean section effectively maintained fluid balance and it was associated with rapid return of propulsive bowel movements, successful breast feeding, less side effects and shorter hospital stay than the conventional intravenous hydration. So, it should be used in most cases after elective cesarean section.
Abd Rabbo
S
S
Department of Obstetrics and Gynecology, Shatby Maternity University Hospital, Alexandria University, Egypt.
D000328:Adult; D002585:Cesarean Section; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007262:Infusions, Intravenous; D011183:Postoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome