• Xiang-Yang Chang, Li-Zhong Wang, Feng Xia, and Yin-Fa Zhang.
• 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.

BackgroundAlthough 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.MethodsUltrasound 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- 1.ResultsNo 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 mm2 vs.350 mm2 in supine, 571 mm2 vs.480 mm2 in RLD, P < 0.05) and cut-off values of antral area to discriminate a risk stomach (510 mm2 vs. 453 mm2 in supine, 670 mm2 vs. 605 mm2 in RLD).ConclusionsThis 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.© 2022. The Author(s).

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