Ultrassom de antro gástrico em gestantes a termo antes de cesariana eletiva

Abstract

Background and objectivesPregnant women are considered patients at risk for pulmonary aspiration of gastric contents. The study aim was to evaluate the gastric antral cross‐sectional area using ultrasound. MethodIn this prospective study, 85 scheduled term pregnant women underwent gastric ultrasound. The outcomes were the measurement of the gastric antral cross‐sectional area (main outcome), the estimated gastric volume, the incidence of pregnant women at risk for pulmonary aspiration, and the association between gastric antral cross‐sectional area and clinical‐demographic characteristics. Gastric antral cross‐sectional area and gastric volume were compared according to body mass index <30 or ≥ 30. ResultsThe median (IIQ) for gastric antral cross‐sectional area was 4cm2 (2.8‐6.3), for the estimated gastric volume it was 49.8mL (33.7‐87.2), and for the gastric volume estimated in mL.kg−1 it was 0.62mL.kg−1 (0.39‐0.95). The 95th percentile [95% confidence interval (CI)] of the gastric antral cross‐sectional area and the estimated gastric volume were ≤ 10.3cm2 (95% CI: 7.6‐15.6) and 1.42mL.kg−1 (95% CI: 1.20‐2.64), respectively. The incidence of pregnant women at risk for pulmonary aspiration was 3.5% (CI: 3.5 (1.2‐9.8). There was a positive correlation between gastric antral cross‐sectional area and weight, p <0.001 and body mass index <0.001. Patients with a body mass index ≥ 30 had a gastric antral cross‐sectional area and an estimated gastric volume greater than those with a body mass index <30, respectively, p <0.01 and p <0.02. ConclusionMeasuring the gastric antral cross‐sectional area of pregnant women is feasible and easy. There was positive correlation between gastric antral cross‐sectional area, body weight and body mass index. The estimation of gastric volume by measuring the gastric antral cross‐sectional area can identify patients at risk for pulmonary aspiration. Obese patients had a gastric antral cross‐sectional area and an estimated gastric volume greater than non‐obese patients.