From fasting to feasting: Unraveling the postoperative benefits of preoperative carbohydrate intake in cesarean delivery—A systematic review and meta-analysis
R.A. Kasem , A. Attalla , A. Ramadan , A. Tawfik , A. Salmona , M.K. AbdElhaseeb
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引用次数: 0
Abstract
Objectives
Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).
Methods
A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.
Results
We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD = −0.58, 95% CI [−0.95 to −0.21], P = 0.002) and insulin resistance (SMD = −0.32, 95% CI [−0.58 to −0.07], P = 0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR = 0.96, 95% CI [0.77–1.20], P = 0.73), the amount of bleeding (SMD = −0.17, 95% CI [−0.52 to 0.18], P = 0.34) or plasma glucose levels (SMD = −0.12, 95% CI [−0.29 to 0.05], P = 0.17).
Conclusion
Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.
期刊介绍:
Una excelente publicación para mantenerse al día en los temas de máximo interés de la ginecología de vanguardia. Resulta idónea tanto para el especialista en ginecología, como en obstetricia o en pediatría, y está presente en los más prestigiosos índices de referencia en medicina.