Acid aspiration prophylaxis in labour: a survey of UK obstetric units

Abstract

The risk of acid aspiration is still a major concern in pregnant patients. In view of the increasing numbers of drugs available to decrease gastric acid production, it seemed timely to reassess acid aspiration prophylaxis policies in the UK. An OAA-approved postal survey of 250 UK lead consultant obstetric anaesthetists was conducted in 2004 in order to establish the current practice of acid aspiration prophylaxis in labour. If acid aspiration prophylaxis was used, further questions were asked relating to subgroups of patients, category, dose and route of administration of drugs used and whether there was an anticipated change in practice. A response rate of 83% was achieved. There had been a decrease in the routine use of acid aspiration prophylaxis to 32% of units, an increase in the use of acid aspiration prophylaxis in "at risk" groups to 61% and a decrease in the number of units never using prophylaxis to 7%. Oral ranitidine administered six-hourly is the most common practice. There is little use of proton pump inhibitors. Compared to previous surveys of UK practice there has been an overall increase in the use of acid aspiration prophylaxis.