Severity and Contributing Factors of Abdominal Distension After Cesarean Section in Women

Abstract

Purpose: This study was conducted to determine the severity of abdominal distension (AD) after cesarean section in women and the factors affecting it. Material and Methods: This cross-sectional study was conducted between January and June 2025 with 176 women who underwent cesarean section in Turkey. Data were collected using the “Personal Information Form”, “Postoperative Information Form” and “Visual Analog Scale (VAS)”. Descriptive statistics, t-test, ANOVA test and multiple regression analysis were used to analyze the data. Results: The mean duration of first gas output, AD and VAS severity of the participants after cesarean section were 16.0±6.65 hours, 4.67±0.90 and 4.42±0.87, respectively. According to multiple regression analysis, it was found that hemorrhoids, pain and coffee consumption increased AD severity by 1.114, 0.265 and 0.558 unit points, respectively, and defecation once a day and 2-4 times a week in the last month of pregnancy decreased it by 0.749 and 0.777, respectively. Conclusion: It is recommended that women should be provided with education and counseling to prevent the risk factors that increase the severity of AD starting from the gestational period, awareness of healthcare professionals should be increased in this regard, and patients should be closely monitored for distension after cesarean section. Keywords: Abdominal distension; cesarean section; pain; postoperative care; postoperative complications .

Keywords

• abdominal distension;
• cesarean section;
• pain;
• postoperative care;
• postoperative complications

Sezaryen Sonrası Kadınlarda Abdominal Distansiyonun Şiddeti ve İlişkili Faktörler

Abstract

Amaç: Bu çalışma, sezaryen sonrası kadınlarda algılanan abdominal distansiyon şiddetini tanımlamak ve bununla ilişkili faktörleri incelemek amacıyla yapılmıştır. Gereç ve Yöntem: Bu kesitsel çalışma, Ocak–Haziran 2025 tarihleri arasında Türkiye’de sezaryen ile doğum yapan 176 kadın ile gerçekleştirilmiştir. Veriler, Kişisel Bilgi Formu, Postoperatif Bilgi Formu ve Görsel Analog Skala (VAS) kullanılarak toplanmıştır. Verilerin analizinde tanımlayıcı istatistikler ile birlikte t-testi, tek yönlü varyans analizi (ANOVA) ve çoklu doğrusal regresyon analizi kullanılmıştır. Bulgular: Sezaryen sonrası katılımcıların ilk gaz çıkarma süresi, abdominal distansiyon (AD) şiddeti ve VAS puanı ortalamaları sırasıyla 16,0±6,65 saat, 4,67±0,90 ve 4,42±0,87 olarak bulunmuştur. Çoklu regresyon analizine göre, hemoroid varlığı, ağrı düzeyi ve kahve tüketiminin AD şiddeti ile pozitif yönde ilişkili olduğu; günlük bir kez ve haftada 2–4 kez dışkılama sıklığının ise AD şiddeti ile negatif yönde ilişkili olduğu belirlenmiştir. Sonuç: Abdominal distansiyon (AD) şiddetini artıran risk faktörlerinin önlenmesine yönelik olarak, gebelik döneminden itibaren kadınlara eğitim ve danışmanlık verilmesi, bu konuda sağlık profesyonellerinin farkındalığının artırılması ve sezaryen sonrası dönemde hastaların distansiyon açısından yakından izlenmesi önerilmektedir. Anahtar kelimeler: Abdominal distansiyon, sezaryen, ağrı, postoperatif bakım, postoperatif komplikasyonlar

Keywords

• Abdominal distansiyon
• sezaryen
• ağrı
• postoperatif bakım
• postoperatif komplikasyonlar

References

1. Alphones, C. K., Miranda, J. P. (2023). Effectiveness of planned early ambulation on postoperative recovery among cesarean mothers: A quasi-experimental study in Mangaluru. Journal of Health and Allied Sciences, 13(4), 551–556. https://doi.org/10.1055/s-0043- 1761212
2. Barai, D., Vahitha, S. (2019). Effectiveness of early ambulation on post-operative recovery among primiparous post-cesarean mothers: A randomized controlled trial. International Journal of Science and Research, 8(1), 3–6. https://doi.org/10.36106/ijsr
3. Goymen, A., Şimşek, Y., Ozkaplan, S. E., Ozdurak, H. İ., Akpak, Y. K., Semiz, A., et al. (2017). Effect of gum chewing and coffee consumption on intestinal motility in caesarean sections. Journal of Clinical and Analytical Medicine, 8, 411–415.
4. Gürkan, A., Aldemir, K., Andsoy, İ. İ., Gül, A. (2020). Comparison of four different pain scales in the evaluation of postoperative acute pain intensity. Çukurova Medical Journal, 45(4), 1562–1571. https://doi.org/10.17826/cumj.741465
5. Hassan, E. H., El-Sadek, A. N. E., Ali, L. A. H. (2019). Effect of three different nursing interventions on intestinal motility and women’s satisfaction post-cesarean section birth. American Journal of Nursing Research, 7(6), 932–941. https://doi.org/10.12691/ajnr-7-6-4
6. İzveren, Ö. A., Dal, Ü. (2011). Early postoperative problems in patients undergoing abdominal surgery and nursing interventions for these problems. Hacettepe University Faculty of Health Sciences Nursing Journal, 18, 36–46.
7. Kaplan, S., Abay, H. (2024). Physiology, assessment and nursing care in the postpartum period. In G. Ertem (Ed.), Fundamentals of obstetrics, women's health and diseases nursing (pp. 431–454). Ankara: Akademisyen Publishing House. Kırtıl, İ., Kanan, N. (2023). Early and targeted mobilization after surgical interventions. B Med J, 7(2), 41–55. https://doi.org/10.5281/zenodo.1381699
8. Kırtıl, İ., Kanan, K., Karip A. B. (2023). Effects of a mobilization program applied to bariatric surgery patients on preventing gastrointestinal complications: A quasi-experimental study. Obesity Surgery, 33, 1820–1830. https://doi.org/10.1007/s11695-023- 06609-z

9. Lacy, B. E., Cangemi, D., Vazquez-Roque, M. (2021). Management of chronic abdominal distension and bloating. Clinical Gastroenterology and Hepatology, 19, 219–231. https://doi.org/10.1016/j.cgh.2020.03.056.
10. Latha, S., Kamath, N., Joseph, G. (2023). Postoperative discomfort among laparotomy patients from a selected hospital at Mangaluru: An observational study. Journal of Health and Allied Sciences NU, 13, 509–517. https://doi.org/10.1055/s-0042-1760234.
11. Mari, A., Backer, F. A., Mahamid, M., Amara, H. (2019). Bloating and abdominal distension: Clinical approach and management. Advances in Therapy, 36, 1075– 1084. https://doi.org/10.1007/s12325-019-00924-7.
12. Organisation for Economic Co-operation and Development. (2024). OECD health statistics 2024. https://www.oecd.org/en/data/datasets/oecdhealth- statistics.html
13. Robleda, G., Banos, J. (2021). Health care professionals’ assessment of patient discomfort after abdominal surgery. Journal of PeriAnesthesia Nursing, 36(5), 553– 558. https://doi.org/10.1016/j.jopan.2020.11.007
14. Sahin, E., Terzioğlu, F. (2015). The effect of gum chewing, early oral hydration, and early mobilization on intestinal motility after cesarean birth. Worldviews on Evidence-Based Nursing, 12(6), 380–388. https://doi.org/10.1111/wvn.12125
15. Serçekuş, P., Aksu, D. (2024). Physiological and psychological changes during pregnancy. In G. Ertem (Ed.), Fundamentals of obstetrics, women's health and diseases nursing (pp. 173–184). Ankara: Akademisyen Publishing House.
16. Taşkın, L. (2024). Obstetrics and women's health nursing (19th ed.). Ankara: Akademisyen Publishing House.
17. Ünver, S., Yıldız Fındık, Ü. (2019). Postoperative gastrointestinal system complications and nursing care. In Ü. Yıldız Fındık (Ed.), Postoperative complications and nursing care (1st ed., pp. 30–36). Ankara: Türkiye Klinikleri.
18. Watanabe, J., Miki, A., Koizumi, M., Kotani, K., Sata, N. (2021). Effect of postoperative coffee consumption on postoperative ileus after abdominal surgery: An updated systematic review and meta-analysis. Nutrients, 13, 4394. https://doi.org/10.3390/nu13124394.
19. Yang, T. W., Wang, C. C., Sung, W. W., Ting, W. C., Lin, C. C., Tsai, M. C. (2022). The effect of coffee/caffeine on postoperative ileus following elective colorectal surgery: A meta-analysis of randomized controlled trials. International Journal of Colorectal Disease, 37, 623–630. https://doi.org/10.1007/s00384-021-04086-3
20. Yılmaz, C., YılmazEker, P. (2024). Outcomes of abdominal massage in surgical patients: A traditional review. Journal of Health Science Clinical Research, 3(3), 184– 193. https://doi.org/10.5281/zenodo.14576670