Poster Session 3
Category: Operative Obstetrics
Poster Session 3
Fabrizio Zullo, MD (he/him/his)
Ob/Gyn Resident
University of Rome La Sapienza
Rome, Lazio, Italy
Moti Gulersen, MD, MSc
Assistant Professor
Thomas Jefferson University
PHILADELPHIA, Pennsylvania, United States
Sahithi Talasila
Jefferson University
Philadelphia, Pennsylvania, United States
Gabriele Saccone, MD, PhD
Università degli Studi di Napoli Federico II
Napoli, Campania, Italy
Antonio F. Saad, MBA, MD (he/him/his)
Director of Perinatal Research Unit, MFM Fellowship Program Director
Inova Fairfax Hospital
Falls Church, Virginia, United States
Vincenzo Berghella, MD (he/him/his)
Professor, Director
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
The search was conducted by a medical librarian using PubMed, Google Scholar, OVID, and Cochrane Library as electronic databases from their inception until May 2025, using specific keywords. Selection criteria included RCTs of patients with CD comparing EOF (intervention group) to delayed oral feeding (control group). EOF was defined as a liquid and/or solid diet < 24 hours of CD. Delayed oral feeding was defined as feeding > 24 hours or as defined by the original trial.
Analyses were done using an intention-to-treat approach. The primary outcome was hospital length of stay (LOS). Secondary outcomes included mean time intervals to first flatus and bowel sounds and presence of nausea, vomiting, and ileus symptoms .A subgroup analysis for EOF ≤ 6 hours was performed. The summary measures were reported as relative risk (RR) or mean difference (MD) with a 95% CI using the fixed-effects model of DerSimonian and Laird. I-squared (Higgins I2) was used to identify heterogeneity. (CRD42022314823)
Results:
Data from 24 RCTs and 5760 participants were included (2884 vs 2876). Patients in the EOF group (usually < 12 hours after CD) had a significantly shorter postoperative LOS (MD -0.21 days, 95% CI -0.23 to -0.19), and shorter time interval to first flatus (MD -5.38 hours, 95% CI -5.73 to – 5.03), and first bowel sounds (MD -5.07 hours, 95% CI -5.38 to – 4.76) compared to controls. The rates of nausea, vomiting, and ileus symptoms were similar between the two groups. (Table 1). In the subgroup analysis, EOF < 6hours after CD was also associated with significantly shorter LOS, shorter time interval to first flatus, and to first bowel sounds, compared to delayed oral feeding
Conclusion:
Early oral feeding – as early as < 6 hours - after CD is associated with a reduced LOS and time interval to first flatus and bowel sounds compared to controls, without increasing GI symptoms. These findings support the safety and benefit of early postoperative feeding ≤ 6 hours in this population.