Department of Anesthesiology, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, 314000, Zhejiang, China.
BMC Anesthesiol. 2022 Feb 7;22(1):41. doi: 10.1186/s12871-022-01582-z.
Although restricting food intake during labor is recommended by guidelines, intrapartum starvation has not been popular in some regions. We conducted this comparative cross-sectional study to determine the prevalence of risk stomach in non-fasted laboring women compared with fasted non-laboring women using gastric ultrasound.
Ultrasound examination of the antrum was performed in 50 term fasted non-laboring women before elective cesarean delivery and 50 laboring women allowed to eat and drink during active labor. Examinations consisted of the qualitative (antral grades, 0-3) and quantitative evaluation (antral cross-sectional area and calculated gastric volume) in the supine and right lateral decubitus (RLD) position. A risk stomach was defined as an antral grade ≥ 2 or grade 1 with gastric volume ≥ 1.5 ml· kg.
No non-laboring women had grade ≥ 2, while 34 (68%) laboring women had grade ≥ 2. Nine (18%) non-laboring and 40 (80%) laboring women presented risk stomach (P < 0.001) (risk ratio: 4.4, 95% CI 2.4-8.2). Compared with non-laboring women, laboring women had larger antral area at "empty" stomach (grade 0) (437 mm vs.350 mm in supine, 571 mm vs.480 mm in RLD, P < 0.05) and cut-off values of antral area to discriminate a risk stomach (510 mm vs. 453 mm in supine, 670 mm vs. 605 mm in RLD).
This study confirms a higher prevalence of risk stomach presents in laboring women under a liberal eating policy, gastric ultrasound is therefore useful for this risk population if general anesthesia is required unexpectedly.
尽管指南建议限制分娩期间的进食，但在一些地区，产程中饥饿并未得到广泛认可。我们进行了这项对比性的横断面研究，使用胃超声检查来确定与禁食未临产的妇女相比，非禁食临产妇女中风险性胃的发生率。
在选择性剖宫产前，对 50 名足月禁食未临产的妇女和 50 名在活跃产程中允许进食和饮水的临产妇女进行胃窦超声检查。检查包括仰卧位和右侧卧位（RLD）的定性（胃窦分级，0-3 级）和定量评估（胃窦横截面积和计算的胃容量）。胃窦分级≥2 级或 1 级但胃容量≥1.5ml·kg 定义为风险性胃。
没有未临产的妇女出现胃窦分级≥2 级，而 34 名（68%）临产妇女出现胃窦分级≥2 级。9 名（18%）未临产妇女和 40 名（80%）临产妇女出现风险性胃（P<0.001）（风险比：4.4，95%CI 2.4-8.2）。与未临产的妇女相比，临产的妇女在空腹时胃窦区的面积更大（0 级）（仰卧位时为 437mm 对 350mm，RLD 时为 571mm 对 480mm，P<0.05），区分风险性胃的胃窦区面积截断值（仰卧位时为 510mm 对 453mm，RLD 时为 670mm 对 605mm）。
本研究证实，在自由进食政策下，临产妇女中风险性胃的发生率更高，如果意外需要全身麻醉，胃超声对这一风险人群是有用的。
