ASSESSMENT OF RESIDUAL GASTRIC VOLUME IN FULL - TERM PREGNANT WOMEN BEFORE ELECTIVE CESAREAN SECTION

Abstract

Background: Pulmonary aspiration of gastric contents in the perioperative is associated with increased postoperative morbidity and mortality. Pregnant women have been considered to be at particular risk of aspiration syndromes as a consequence of physiological changes during pregnancy. The primary objective is to determine the gastric residual volume using ultrasound in pregnant women undergoing elective cesarean section. The secondary objective is identifying the proportion of pregnant women at high risk of aspiration.

Methods: Cross-sectional descriptive study. We included pregnant women scheduled for elective cesarean section, fasting following hospital protocol (8h after solid foods and 2h after clear liquids). The study took place from December 2022 to April 2023 at Hung Vuong Hospital. Gastric residual volume (GRV) was assessed based on the cross-sectional area (CSA) measured by ultrasound in the right lateral position. Pregnant women with gastric volume normalized by weight (GV) ≥ 1.5 ml/kg or suspicious ultrasound results indicating fluid or solid food residual in the gastric were considered at high risk of aspiration.

Results: A total of 90 pregnant women were included in the analysis. The median age of the pregnant women was 31.9 ± 4.3 years, with the majority undergoing elective cesarean section due to maternal reasons (87%); the median gestational age was 36 (38.2 – 39) weeks. The median GRV in pregnant women was 34.8 (22.45 – 54.32) ml. The median GV was 0.66 (0.48 – 1.01) ml/kg and the proportion of pregnant women at risk of aspiration was 2.2%.

Conclusion: Pregnant women before elective cesarean delivery who fasting protocols are less likely to have a high gastric residual volume.

Keywords: aspiration, gastric residual volume, pregnancy, gastric ultrasound