METHODS: Ultrasound assessments of gastric contents were performed within the first hour after admission to the maternity unit. The prevalence of high-risk gastric contents was calculated and variables associated with high-risk gastric contents were identified using logistic regression analyses.
RESULTS: A total of 1003 parturients were analysed. The prevalence of high-risk gastric contents was 70% (379/544; 95% confidence interval: 66-74%) in women admitted in spontaneous labour and 65% (646/1003; 95% confidence interval: 61-67%) in the whole cohort. Lower gestational age, increased fasting duration for solids, and elective Caesarean delivery were independently associated with reduced likelihood of high-risk gastric contents. In women admitted in spontaneous labour and in the whole cohort, the prevalence of high-risk gastric contents ranged from 85% to 86% for fasting duration for solids <6 h, 63%-68% for fasting 6-8 h, 54%-55% for fasting 8-12 h, and 47%-51% for fasting ≥12 h.
CONCLUSIONS: Around two-thirds of parturients had high-risk gastric contents within the first hour after admission to the maternity unit. Our results suggest that gastric emptying for solids continues in labouring women, and that gastric ultrasound would be most helpful when fasting duration is ≥8 h.
方法:在入院后的第一个小时内对胃内容物进行超声评估。计算了高危胃内容物的患病率,并使用逻辑回归分析确定了与高危胃内容物相关的变量。
结果:共分析了1003例产妇。在自然分娩的女性中,高危胃内容物的患病率为70%(379/544;95%置信区间:66-74%),在整个队列中占65%(646/1003;95%置信区间:61-67%)。胎龄较低,增加固体的禁食时间,和选择性剖腹产与高危胃内容物的可能性降低独立相关。在自然分娩的女性和整个队列中,在固体<6小时的禁食期间,高危胃内容物的患病率为85%至86%,空腹6-8小时63%-68%,空腹8-12小时为54%-55%,
结论:约三分之二的产妇在入院后的第一小时内胃内容物有高风险。我们的结果表明,在劳动妇女中,固体的胃排空仍在继续,禁食时间≥8小时时,胃超声检查将最有帮助。