الفهرس 
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Abstract
Cesarean sections are considered routine procedures and also the most common major hospital surgical procedure performed in the developed and developing world with a low chance of mortality for mother and child (Sean et al., 2010).
Traditionally, patients are not given fluid or food until clinical signs of normal intestinal function return, which is most commonly the presence of bowel sound, a passing of flatus or stool, and the feeling of hunger. The rationale of this practice is to prevent postoperative nausea and vomiting, distention and others complications. However, withholding oral feedings may lead to intestinal ileus, which can prolong the length of hospital stay (LOS) and increase the financial burden (Huaping et al., 2015).
Early feeding can reduce the rate of body protein depletion, improve wound healing, impact positively on psychological status, and reduce the incidence of nosocomial infections, length of hospital stay and treatment cost (Nasrin and Mohammad, 2014).
Aim of the Work
This study aims to compare between the outcomes of early and late oral feeding after cesarean section under regional anesthesia.
The study included 375 women were assessed for eligibility of which 45 women didn’t meet inclusion criteria and 30 women were excluded before randomization due to intraoperative problems like (22 failed spinal anesthesia, 5 with intraoperative hemorrhage, 3 bladder injury).
300 women were included in this study. They were divided into two equal groups:
group A: composed of 150 patients who were encouraged to oral fluid (semi solid and solid) starting 2 h after C- section was performed.
group B: composed of 150 patients who received oral fluid at 8 h following surgery.
The selected women were subjected to the following:
• Proper full history was taken.
• General examination and abdominal examination.
• Trans-abdominal ultrasound for assessment of gestational age, placental site and fetal weight.
• All patients were observed intra-operatively for the degree of adhesion and categorized to it as mild, moderate and severe and also were observed for blood transfusion, and febrile morbidity.
• Patients were observed every 2 hours till discharge.
- Passage of flatus, and stool.
- Adverse effects (fever, nausea, vomiting, distention).
- Occurrence of post-partum hemorrhage.
- Febrile morbidity.
- Length of hospital stay.
- Time to ambulation.
- Patient satisfaction.
- Rehospitalization or wound infection.
• The result of this study showed that there were no significant differences between the 2 groups with respect to mean maternal age, BMI and parity.
• Women in the two groups had similar operative characteristics, including mean duration of surgery, type of anesthesia, and postoperative drugs used there were no significant differences in between the two groups.
• In this study it was found that women in the early oral feeding group had a highly significant shorter hospital staying time than the late oral feeding group (25 (23 – 28) hours versus 27 (24 – 29.5) hours P value 0.001), and a highly significant satisfaction level among early oral feeding group (132 (88.0%) versus 47 (31.3%) P value 0.000). A significantly shorter time to ambulation in early oral feeding group (6 (4.5 – 8.5) hours versus, 6.5 (5 – 9.5) hours P value 0.014), and a significantly higher rate of occurrence of distention among the late oral feeding group (27 (18.0%) versus 15 (10.0%) P value 0.045). No significant differences were identified with respect to nausea, vomiting, time to 1st passing flatus, and time to defecation. Results were the same as regard rehospitalization, and wound infections.