Annales françaises d'anesthèsie et de rèanimation
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Fasting during labour is questioned in France despite the historical recommendations by Curtis Mendelson. Solid food diet increases maternal nausea and vomiting of non digested food associated with a theoretical risk of severe aspiration syndrome. Clear fluids may improve the comfort of some parturients but it remains uncertain whether or not the obstetric consequences (i.e. duration of labour, Caesarean section rate) of carbohydrate supplementation are beneficial.
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Obstetric anaesthesia is a "young" discipline, with constant novelties from a clinical, scientific and academic standpoint. While there is still no official sub-specialty in obstetric anesthesia, this field has become more diversified because of the growing maternal request for labor analgesia, a constant and perhaps even increasing rate of caesarean deliveries of 20-30% depending on institutions and countries, and also due to the raise in "high risk" pregnancies in women carrying various medical conditions such as complex congenital cardiopathies. In their anesthesia training, most residents rotate in the delivery room for three months on average, which should allow them to acquire good practical skills when performing regional analgesia and anesthesia for labor and delivery. ⋯ It should be recommended to develop training programs to improve the technical skills for intubation in pregnant women, which is why anaesthesia simulators may have an important role in the future. In terms of the theoretical knowledge, good academic training programs are required. The physiology of pregnancy and the physiopathology of pregnancy-related disorders justify a thorough and rigorous teaching in order to reduce both maternal and neonatal morbidity and mortality.