Gastric Ultrasound in Pregnant Women at Term

Food residue in the stomach of patients scheduled to have surgery is considered a major risk factor for pulmonary aspiration of gastric contents. The resulting respiratory compromise after aspiration is associated with significant morbidity and mortality. The risk of pulmonary aspiration is especially important in pregnant women, as they may often require surgery without having observed appropriate fasting. A bedside ultrasound assessment fo the status of the gastric content would be of great value for the clinician. This technique has recently been shown very promising in non-pregnant patients and it is important to study its feasibility in the pregnant population.

In this study, patients fast overnight and are randomized to the following groups: empty, fluid (250 mL of apple juice before scanning) or solid (full breakfast). Their gastric contents are then assessed by 3 different anesthesiologists, using ultrasound. At the end of the scanning, the true stomach contents are revealed. The ability of the assessors to accurately predict stomach contents, as well as the inter-observer agreement, will be examined.

Inclusion criteria

• Volunteer non-laboring pregnant women >32 weeks gestation
• 18 years or older
• ASA status I-III
• Weigh between 50 and 120kg
• Height at least 150cm or taller
• Written informed consent

Exclusion criteria

• Known pre-existing abnormal anatomy of the upper GI tract
• Protocol violation