Eating in labour. A randomised controlled trial assessing the risks and benefits

Area of Science:

• Obstetrics and Gynecology
• Metabolic Research
• Anesthesiology

Background:

• Fasting during labor is a common practice to reduce aspiration risk.
• The metabolic and obstetric consequences of allowing oral intake during labor require further investigation.

Purpose of the Study:

• To assess the impact of a light diet during labor on maternal metabolic profile.
• To evaluate the effect of oral intake on labor outcomes.
• To determine the influence on residual gastric volume and aspiration risk.

Main Methods:

• Randomized controlled trial comparing a light diet group (n=48) with a water-only (starved) group (n=46).
• Metabolic markers (beta-hydroxybutyrate, nonesterified fatty acids, glucose, insulin, lactate) were measured.
• Labor duration, delivery mode, Apgar scores, and gastric volume (via ultrasound) were assessed.

Main Results:

• The light diet group showed no rise in beta-hydroxybutyrate or nonesterified fatty acids.
• Plasma glucose and insulin increased in the eating group; no difference in lactate.
• No significant differences in labor duration, delivery mode, or Apgar scores.
• Increased gastric antral cross-sectional area and larger vomited volumes in the eating group.

Conclusions:

• Eating a light diet during labor effectively prevents ketosis.
• Oral intake significantly increases residual gastric volume, potentially raising aspiration risk.
• The findings suggest a trade-off between metabolic benefits and increased gastric volume during labor.