Table 1 The characteristics of included studies
Author(year) | Country | Numbers of participants(GC/NGC) | Gum intervention | Main outcomes | Results |
|---|---|---|---|---|---|
Abd-El-Maeboud 2009 [19] | Egypt | 200(93/107) | Started from 2 h after surgery, lasted for 15 min every 2 h in the daytime but not in the night, until the passage of flatus | ①,②,④,⑤ | Gum chewing after CS is safe, well tolerated, and associated with rapid resumption of intestinal motility and shorter hospital stay |
Ajuzieogu 2014 [20] | Nigeria | 180(90/90) | Started from the first day after operation for 5 consecutive days, 3 times daily, 30 min for every time. | ①,②,④,⑤ | Gum chewing has a beneficial effect on early return of bowel function following cesarean section and should be included in the postoperative management protocol |
Jakkaew 2013 [21] | Thailand | 50(25/25) | Started since the regain of consciousness after operation, 4 times a day (morning, noon, evening, and before bed time), 30 min for every time, until the first passage of flatus | ①,⑤,⑥,⑦ | Gum chewing is associated with faster recovery of bowel function following cesarean section |
Kafali 2010 [22] | Turkey | 150(74/76) | Started from 2 h after surgery, 3 times daily in the morning, afternoon, and evening, each episode of gum chewing lasted 1 h except the initial one which lasted 15 min | ①,④,⑤ | Gum chewing provides a simple method for early recovery of bowel function after cesarean section |
Ledari 2012 [23] | Iran | 100(50/50) | Chewing gum for at least 1 h, three times daily from 6 h after surgery (after recovery from anesthesia) until being discharged | â‘ ,â‘£,â‘¥ | chewing is acceptable and inexpensive physiologic method for decreasing the time to the passage of flatus, bowel movements, and feeling of hunger in patients undergoing cesarean section |
Lee 2016 [24] | China | 120(40/40/40) | Chewing xylitol-free or xylitol-containing gum started from 2 h after surgery, repeated every 2 h between 9 a.m. and 8 p.m, 15 min for every time, until the first passage of flatus | ①,②,④ | After cesarean section, chewing gum increased participants’ return of bowel activity and xylitol-containing gum may be superior to xylitol-free gum |
Liang 2007 [25] | China | 120(60/60) | Started after recovery from anesthesia, repeated every 2 h for 15 min every time | ①,②,⑦,⑧ | Chewing gum can promote gastrointestinal motility recovery after cesarean section, and the method is simple, convenient, safe |
Luo 2010 [26] | China | 300(150/150) | Started from 2 h after surgery, 4 times daily in the morning, afternoon, and evening, each episode of gum chewing lasted 10-15min | ①,②,④,⑦,⑨ | Chewing gum can promote the recovery of gastrointestinal function after cesarean section |
Shang 2010 [27] | China | 386(195/191) | Chew gum for at least half an hour, three times per day after returning to the ward | ①,②,④,⑤,⑩ | Gum chewing is an inexpensive, convenient, and physiological method in enhancing the recovery of bowel function |
Zamora 2012 [28] | Philippines | 53(18/35) | Gum chewing involved chewing two pellets of sugarless gum at 12 h post operation for 15 min then advanced to sips of clear liquids at 16 h post operation | ①,③,⑤,⑩ | Postoperative gum chewing stimulates the earlier return of bowel motility after cesarean delivery |