From the Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Bron (LJ, BC, FPD, MP, PB, AB, DC, LB), University of Lyon, Claude Bernard Lyon 1 University, Villeurbanne (DC, LB), Inserm, U1032, LabTau, Lyon (LB), the Department of Anaesthesia and Intensive Care, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille (LZ, ML), and the Aix Marseille University, Marseille, France (ML).
Eur J Anaesthesiol. 2017 Mar;34(3):150-157. doi: 10.1097/EJA.0000000000000488.
Ultrasound measurement of the antral cross-sectional area of the stomach, performed in the supine position, has been described for preoperative assessment of gastric content in the adult, but, to date, no study has determined the cut-off value of the antral area for the diagnosis of an empty stomach in the parturient. Nevertheless, previous studies in parturients have reported that the use of a simple qualitative grading scale (0 to 2) was reliable for the estimation of the gastric fluid volume. However, this qualitative grading score requires turning the parturient into the right lateral decubitus position for the ultrasound examination, something which may not be easily feasible, particularly in the case of an obstetric emergency.
To calculate the cut-off value of the antral area, measured in the supine position during established labour, for the diagnosis of 'empty' stomach.
A prospective cohort study.
Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France.
Seventy-three women in established labour.
For each parturient, ultrasound assessment of gastric contents was performed in the supine and right lateral decubitus position and scored 0 to 3 on a qualitative grading scale. This assessment was followed by ultrasound measurement of the antral cross-sectional area in both the supine and right lateral positions.
To assess the performance of the antral area measured in the supine position for the diagnosis of an 'empty' stomach (gastric antrum grade 0), a receiver operating characteristic curve was plotted, and the area under the receiver operating characteristic curve was calculated.
Data from 73 women were analysed. For the diagnosis of grade 0, the cut-off value for the antral area measured in the supine position was 381 mm (sensitivity, 81%; specificity, 76% and negative predictive value, 80%).
With a parturient lying in the supine position, a single assessment of the antral cross-sectional area may be used for the fast diagnosis of an empty stomach. This tool could be useful in assessing the risk of aspiration for parturients who require emergency anaesthesia during labour.
超声测量胃窦横截面积，取仰卧位，已被描述为成人术前评估胃内容物，但迄今为止，尚无研究确定胃窦面积的截止值，以诊断产妇空腹。然而，以前在产妇中的研究报告称，使用简单的定性分级量表（0 到 2）对于估计胃液体量是可靠的。然而，这种定性分级评分需要将产妇转为右侧卧位进行超声检查，这在产科急症的情况下可能不容易实现。
计算仰卧位时在已建立的分娩过程中测量的胃窦横截面积的截止值，以诊断“空”胃。
前瞻性队列研究。
法国里昂 Hospices Civils de Lyon，Hôpital Femme Mère Enfant，里昂。
73 名处于已建立分娩的女性。
对于每位产妇，在仰卧位和右侧卧位进行胃内容物超声评估，并在定性分级量表上评为 0 到 3 分。然后在仰卧位和右侧卧位测量胃窦横截面积。
评估仰卧位测量的胃窦横截面积对诊断“空”胃（胃窦等级 0）的性能，绘制受试者工作特征曲线，并计算受试者工作特征曲线下的面积。
分析了 73 名女性的数据。对于诊断等级 0，仰卧位测量的胃窦横截面积的截止值为 381mm（敏感性为 81%，特异性为 76%和阴性预测值为 80%）。
产妇仰卧位时，单次胃窦横截面积评估可用于快速诊断空腹。对于需要在分娩期间紧急麻醉的产妇，该工具可用于评估吸入风险。
