Chewing gum improves postoperative recovery of gastrointestinal function after cesarean delivery: a systematic review and meta-analysis of randomized trials.

Abstract

OBJECTIVE:

To examine whether chewing gum hastens the return of gastrointestinal function after a cesarean delivery.

METHODS:

All randomized controlled trials comparing the use of chewing gum in the immediate postoperative recovery period (i.e. intervention group) with a control group were included in the meta-analysis. The primary outcome was the time to first flatus in hours. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary treatment effects in terms of mean difference (MD) or relative risk (RR) with 95% confidence interval (CI).

RESULTS:

Seventeen trials, including 3041 women, were analyzed. Trials were of moderate to low quality with different inclusion criteria. In most of the included trials chewing gum was given right after delivery, three times a day for 30 min each and until the first flatus. Women who were randomized to the chewing gum group had a significantly lower mean time to first flatus (MD - 6.49 h, 95%CI -8.65 to -4.33), to first bowel sounds (MD - 8.48 h, 95%CI -9.04 to -7.92), less duration of stay (MD - 0.39 days, 95%CI -0.78 to -0.18), lower time to first feces (MD - 9.57 h, 95% CI -10.28 to 8.87) and to the first feeling of hunger (MD - 2.89 h, 95%CI -4.93 to -0.85), less number of episodes of nausea or vomiting (RR 0.33, 95%CI 0.12 to 0.87), less incidence of ileus (RR 0.39, 95%CI 0.19 to 0.80) and significantly higher satisfaction.

CONCLUSIONS:

Gum chewing starting right after cesarean delivery three times a day for about 30 min until the first flatus is associated with early recovery of bowel motility. As this is a simple, generally inexpensive intervention, providers should consider implementing cesarean postoperative care with gum chewing.

• Authors: Andrea Ciardulli, Gabriele Saccone, Daniele Di Mascio, Claudia Caissutti, Vincenzo Berghella
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 31 Issue 14 Pg. 1924-1932 (Jul 2018) ISSN: 1476-4954 [Electronic] England
• PMID: 28502203 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)

Chemical References

• Chewing Gum

Topics

• Cesarean Section (rehabilitation)
• Chewing Gum
• Female
• Gastrointestinal Motility
• Humans
• Postoperative Care
• Pregnancy
• Randomized Controlled Trials as Topic