Impact of oral carbohydrate consumption prior to cesarean delivery on preoperative well-being: a randomized interventional study

Wendling, Adam; Byun, Sharon; Koenig, Megan; Vasilopoulos, Terrie

doi:10.1007/s00404-020-05455-z

Cited by 15 publications

(29 citation statements)

References 34 publications

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“…Another previous study showed that the duration of fluid fasting in women undergoing elective CD was correlated with thirst scores and urine osmolality [ 20 ]. Meanwhile, latest findings from Wendling et al found that a higher-dose carbohydrate beverage consumed preoperatively resulted in superior well-being compared to fasting, which was consistent with our findings [ 21 ]. However, considering patients were not blind in our study, bias may have occurred accordingly.…”

Section: Discussionsupporting

confidence: 92%

“…On the other hand, intravenous glucose solution administered during the CD has increased both the maternal and neonatal glucose level [ 27 ]. We noticed that the mean umbilical cord blood glucose level of those who had drunk preoperative oral carbohydrate beverage in Wendling et al’s study was relative higher ( p > 0.05) [ 21 ]. Fortunately, with a larger sample size, a significant difference was obtained in our study.…”

Section: Discussionmentioning

confidence: 99%

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The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial

Liu

Han

et al. 2021

BMC Pregnancy Childbirth

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Background To evaluate the impact of oral carbohydrate-rich (Ch-R) supplement taken 2 hours before an elective caesarean delivery (CD) on maternal and neonatal perioperative outcomes. Methods Ninety pregnant women undergoing elective CD were randomized into the Ch-R group, placebo group and fasting group equally. Participants’ blood was drawn at three time points, before intervention, immediately after and 1 day after the surgery to measure maternal and neonatal biochemical indices. Meanwhile women’s perioperative symptoms and signs were recorded. Results Eighty-eight pregnant women were finally included in the study. Women who had drunk Ch-R supplement had lower postoperative insulin level (β = − 3.50, 95% CI − 5.45 to − 1.56), as well as postoperative HOMA-IR index (β = − 0.74, 95% CI − 1.15 to − 0.34), compared with women who had fasted. Additionally, neonates of mothers who were allocated in the Ch-R group also had a higher glucose level, compared with neonates of mothers in the fasting group (β = 0.40, CI 0.17 to 0.62). Conclusion Oral Ch-R solution administered 2 hours before an elective CD may not only alleviate maternal postoperative insulin resistance, but also comfort women’s preoperative thirst and hunger, compared to fasting. Additionally, it may increase neonatal glucose level as well. Trial registration Chinese Clinical Trial Registry, ChiCTR2000033163. Data of Registration: 2020-5-22.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial

Liu

Han

et al. 2021

BMC Pregnancy Childbirth

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“…However, pregnant women were not included due to high risk of aspiration related to reduced lower esophageal sphincter tone and delayed gastric emptying. In 2018, the guidelines for postoperative care in cesarean delivery released by ERAS surgery pointed out that oral carbohydrate supplementation of 12.5% is recommended for nondiabetic pregnant women 2 h before cesarean delivery to reduce postoperative insulin resistance 8,9 A study compared high‐dose carbohydrate beverages made for preoperative consumption to common, commercial oral rehydration solutions with low carbohydrate concentrations, and found that either a common oral rehydration beverage or a high‐dose carbohydrate beverage consumed preoperatively resulted in superior well‐being compared with fasting 10 …”

Section: Introductionmentioning

confidence: 99%

“…Several factors contribute to the increase of blood glucose, including impaired insulin secretion, hepatic gluconeogenesis, and increased insulin resistance 11 . Long preoperative fasting time and insufficient energy supply may increase the risk of maternal and neonatal hypoglycemia, induce maternal postoperative insulin resistance, and effect the safety of both the maternal and neonatal outcomes 10 . There is a lack of studies concentrating on the preoperative diet in GDM patients.…”

Section: Introductionmentioning

confidence: 99%

Safety and feasibility of oral carbohydrate consumption before cesarean delivery on patients with gestational diabetes mellitus: A parallel, randomized controlled trial

Liu

Jin

Wang

et al. 2021

J of Obstet and Gynaecol

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Aim To investigate the safety and feasibility of taking low‐concentration carbohydrate solution at 2 h before induction of anesthesia for gestational diabetes mellitus (GDM) patients. Methods GDM patients undergoing cesarean section were randomly assigned to experimental group (n = 43) and control group (n = 42). Two hours before induction of anesthesia, participants in experimental group orally received 300 mL low‐concentration carbohydrate solution, while those in control group received equivalent warm water. Blood glucose and serum insulin were measured at 2 h before induction of anesthesia, right before induction of anesthesia, and the morning of postoperative day 1. Neonatal blood glucose level was monitored at birth. Maternal gastrointestinal function and well‐being were assessed perioperatively. Results The levels of blood glucose and serum insulin right before induction of anesthesia in the experimental group were significantly higher than those in the control group. There were four cases with hypoglycemia in the experimental group and 19 cases in the control group right before induction of anesthesia (9.3% vs 45.2%, p < 0.001). The incidence of neonatal hypoglycemia was 2.3% in the experimental group and 7.1% in the control group with no significance. Hunger score of the participants between the two groups right before induction of anesthesia was significantly different. No aspiration, nausea, and vomiting occurred in both groups before, during, and after surgery. No significant difference was found in the time to the first flatus and abdominal distension between the two groups. Conclusion Taking low‐concentration carbohydrate solution is safe and feasible for patients with GDM undergoing elective cesarean section.

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“…Oral fluid and carbohydrate supplementation are important for the preoperative well-being of obstetric patients [ 29 ] so, in this study higher number of elective CDs took oral fluid and carbohydrate supplementation (33.5% vs. 35.4%) than eating a light meal (3.1%). The possible reason may be to ease of supplementation of oral fluids than a light meal.…”

Section: Discussionmentioning

confidence: 82%

Practice towards perioperative care of cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia: Cross-sectional study

Fentie¹,

Taye²,

Seid³

2022

Annals of Medicine &Amp; Surgery

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Impact of oral carbohydrate consumption prior to cesarean delivery on preoperative well-being: a randomized interventional study

Cited by 15 publications

References 34 publications

The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial

The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial

Safety and feasibility of oral carbohydrate consumption before cesarean delivery on patients with gestational diabetes mellitus: A parallel, randomized controlled trial

Practice towards perioperative care of cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia: Cross-sectional study

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