Premium
Effects of gum chewing on postoperative bowel motility after caesarean section: a meta‐analysis of randomised controlled trials
Author(s) -
Zhu YP,
Wang WJ,
Zhang SL,
Dai B,
Ye DW
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12662
Subject(s) - medicine , randomized controlled trial , meta analysis , cochrane library , confidence interval , caesarean section , defecation , ileus , relative risk , physical therapy , pregnancy , biology , genetics
Background Gum chewing has been reported to enhance bowel motility and reduce postoperative ileus ( POI ). However, the efficacy remains imprecise for women following caesarean section. Objectives To summarise and evaluate the current evidence for postoperative gum chewing on the recovery of bowel function following caesarean section. Search strategy We searched studies from the following electronic databases: PubMed, EMBASE , SCOPUS and Cochrane Library from inception to 30 May 2013. Selection criteria We included randomised controlled trials ( RCT s) of women after caesarean section; these RCT s should compared gum chewing with no gum chewing and reported on at least one of the outcomes: time to flatus, time to bowel sound, time to passing stool and length of hospital stay ( LOS ). Data collection and analysis Study outcomes were presented as mean differences (for continuous data) with 95% confidence interval (95% CI ). The risk of bias in the study results was assessed using the assessment tool from the Cochrane Handbook. Main results Six RCT s including 939 women were included in our meta‐analysis. The pooled results demonstrated that gum chewing is superior to no gum chewing with a reduction of 6.42 hours (95% CI −7.55 to −5.29) for time to first flatus, 3.62 hours (95% CI −6.41 to −0.83) for time to first bowel sound, 6.58 hours (95% CI −10.10 to −3.07) for time to first stool and 5.94 hours (95% CI −9.39 to −2.49) for LOS . In addition, no evidence emerged for any side effects caused by gum chewing. Conclusions The current evidence suggests that gum chewing is associated with early recovery of bowel motility and shorter LOS for women after caesarean section. This safe and inexpensive intervention should be included in routine postoperative care following a caesarean section.