Ultrasound your NPO: Effect of body mass index on gastric volume in term pregnant women - Retrospective case series

Efrain Riveros-Perez; Sherwin Davoud; Maria Gabriela Sanchez; Hugo Montesinos; Alexander Rocuts

doi:10.1016/j.amsu.2019.10.029

Ultrasound your NPO: Effect of body mass index on gastric volume in term pregnant women - Retrospective case series

Ann Med Surg (Lond). 2019 Nov 6:48:95-98. doi: 10.1016/j.amsu.2019.10.029. eCollection 2019 Dec.

Authors

Efrain Riveros-Perez^{1

2}, Sherwin Davoud³, Maria Gabriela Sanchez⁴, Hugo Montesinos⁵, Alexander Rocuts⁴

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, USA.
² The Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.
³ Medical College of Georgia, USA.
⁴ Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, USA.
⁵ College of Social Science Sand Public Policy, Florida State University, Tallahassee, FL, USA.

Abstract

Introduction: A common belief has been that obese patients are prone to develop aspiration of gastric contents when general anesthesia is administered. We aimed to determine the correlation between antral cross-sectional area as a surrogate of gastric volume measured by gastric ultrasound, and body mass index (BMI) in term pregnant women scheduled for elective cesarean section.

Methods: A cross-sectional observational study was conducted on forty-two term pregnant patients scheduled for cesarean section. A preoperative qualitative and quantitative ultrasound assessment of the antral area was performed on the day of surgery. Gastric volume as a function of BMI was evaluated.

Results: A significant correlation was found between BMI and gastric antral area (p = 0.001), as well as with longitudinal diameter (p < 0.001). This correlation is independent of gravidity and parity.

Conclusion: BMI is an independent predictor of antral cross sectional area and gastric volume in term pregnant patients scheduled for cesarean section. Perioperative fasting guidelines in pregnancy should be adjusted in obese and morbidly obese pregnant women.

Keywords: Antral area; Gastric volume; Pregnancy; Preoperative fasting; Ultrasound.

Publication types

Case Reports