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足月妊娠患者的胃容量与非妊娠女性相似:一项单中心队列研究。

Term pregnant patients have similar gastric volume to non-pregnant females: a single-centre cohort study.

机构信息

Department of Anaesthesia, AZ Monica, Deurne, Belgium; UMC Radboud, Nijmegen, The Netherlands.

Department of Anaesthesiology, Antwerp University Hospital, Edegem, Belgium.

出版信息

Br J Anaesth. 2019 Jan;122(1):79-85. doi: 10.1016/j.bja.2018.07.025. Epub 2018 Aug 29.

Abstract

BACKGROUND

The physiological changes of pregnancy can increase the risk of peri-partum pulmonary aspiration. There is limited objective information regarding gastric volumes in pregnant patients. The aim of this cohort study was to characterise prospectively the range of gastric-fluid volume in term non-labouring pregnant patients compared with a historical cohort of non-pregnant females.

METHODS

Fasted non-labouring term pregnant patients scheduled for elective Caesarean delivery underwent a standardised gastric ultrasound examination. Gastric content was evaluated qualitatively (type of content), semi-quantitatively (Perlas grades), and quantitatively (volume). The antral cross-sectional area and volume were compared with those of a retrospective cohort of non-pregnant females from the same institution. Descriptive statistics were used to describe the central tendency through mean and median values. Dispersion was evaluated with standard deviation and inter-quartile range, and the higher end of the distribution as 95th percentile.

RESULTS

Non-labouring pregnant (59) and non-pregnant (81) subjects were studied. The range of estimated total gastric-fluid volume (P=0.96) and volume per body weight (P=0.78) was not significantly different between cohorts. An estimated volume of 115 ml (102-143) vs 136 ml (106-149) and volume per body weight of 1.4 ml kg (1.2-2.8) vs 2.0 ml kg (1.5-2.7) corresponded to the 95th percentile (95% confidence interval) values in the pregnant and non-pregnant cohort, respectively.

CONCLUSIONS

Baseline gastric volume of non-labouring pregnant patients at term is not significantly different from that of non-pregnant females. This information will be helpful to interpreting findings of gastric point-of-care ultrasound in obstetric patients.

摘要

背景

妊娠的生理变化会增加围产期肺吸入的风险。关于孕妇胃容量的客观信息有限。本队列研究的目的是前瞻性地描述足月未临产孕妇与同一机构非妊娠女性历史队列相比胃内液量的范围。

方法

禁食的足月未临产孕妇行标准胃超声检查。胃内容物定性(内容物类型)、半定量(Perlas 分级)和定量(容量)评估。胃窦横截面积和容量与同一机构非妊娠女性的回顾性队列进行比较。使用均值和中位数描述集中趋势的描述性统计数据。用标准差和四分位间距评估离散度,分布的高端为 95%分位数。

结果

研究了 59 例未临产孕妇和 81 例非妊娠女性。两组的估计总胃液量(P=0.96)和每公斤体重的胃液量(P=0.78)范围无显著差异。估计容量为 115ml(102-143)比 136ml(106-149)和每公斤体重的容量为 1.4ml/kg(1.2-2.8)比 2.0ml/kg(1.5-2.7)分别对应于孕妇和非孕妇队列的 95%分位数(95%置信区间)值。

结论

足月未临产孕妇的基础胃容量与非妊娠女性无显著差异。这些信息将有助于解释产科患者胃床旁超声的发现。

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