ABSTRACT
OBJECTIVE: To assess the effect of preoperative enemas on the postoperative recovery of bowel habits in women undergoing elective cesarean section. STUDY DESIGN: A prospective randomized controlled study with a standard two-group parallel design. The study was registered at the Protocol Registration System of the National Institute of Health (NCT00391599). With an α of 0.05, and a ß of 0.1 (power of 90%) 65 participants were required in each group. The inclusion criteria were elective cesarean section and no history of previous abdominal operations except for cesarean delivery. Randomization was done by random number generator. The study group (n=65) was given a Fleet enema and the controls (n=65) had no preoperative intestinal preparation. The primary outcome measures were postoperative return of bowel sounds, gas passage and first spontaneous feces. Care givers and those assessing the outcomes were blinded to group assignment. RESULTS: On postoperative day 1, among women who had a preoperative enema, 35.3% had bowel sounds, 47.2% had gas passage and 1.5% had spontaneous feces, compared to 47.2%, 52.8%, and 10.8%, respectively, among those who had no enema. The differences were not statistically significant. CONCLUSION: As we could not demonstrate any benefit for preoperative enema, we recommend against routine use of preoperative enema prior to elective cesarean delivery.
Subject(s)
Cesarean Section , Enema/statistics & numerical data , Preoperative Care/methods , Adult , Contraindications , Female , Humans , Postoperative Period , PregnancyABSTRACT
OBJECTIVE: The aim of this study was to assess the decision-to-delivery interval for forceps delivery and vacuum extraction. STUDY DESIGN: A retrospective analysis of all instrumental deliveries over a 1-year period in a delivery ward of a university tertiary health care facility was performed. The decision-to-delivery interval was compared between forceps delivery and vacuum extraction. RESULTS: The decision-to-delivery interval was 8.6+/-5.4 and 13.8+/-6.2 min for forceps and vacuum deliveries, respectively (P=0.0001). CONCLUSION: It appears that it is quicker to accomplish forceps delivery than vacuum extraction.
Subject(s)
Labor Presentation , Obstetric Labor Complications , Parturition , Vacuum Extraction, Obstetrical , Decision Making , Female , Hospitals, University , Humans , Obstetrical Forceps , Pregnancy , Retrospective Studies , Time FactorsABSTRACT
OBJECTIVE: To assess the reported increased rate of cesarean sections in women carrying male fetuses. STUDY DESIGN: A retrospective analysis of all deliveries in 2001 was performed. All singleton deliveries were enrolled. We compared fetal sex distribution in cesarean ased risk of cesarean sections performed for various indications. The study had 80% power to detect a explained by different parturient difference in the cesarean section rate in women carrying male and female fetuses. RESULTS: The overall cesarean section rate was similar in women with male or female fetuses, 19.7% and 19.1%, respectively. This lack of association was also found in specific subgroups of cesarean indications: non-reassuring fetal heart rate pattern, fetal distress, nonprogressive labor, elective cesarean, suspected macrosomia, abnormal lie and severe preeclampsia. CONCLUSION: In contrast with previous investigators, we did not find an increased risk of cesarean section in women carrying male fetuses.
