Pregnancy and Labor Epidural Effects on Gastric Emptying: A Prospective Comparative Study

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Gastroenterology

Background:

• Current guidelines on fasting for solid food during labor lack robust data on gastric emptying.
• Discrepancies exist regarding appropriate fasting protocols for laboring women.

Purpose of the Study:

• To investigate the effect of labor epidural analgesia on gastric emptying of solid food.
• To compare gastric emptying in nonpregnant women, pregnant women, and parturients with and without epidural analgesia.

Main Methods:

• A prospective comparative study involving four groups: nonpregnant women, term pregnant women, parturients without labor analgesia, and parturients with epidural labor analgesia.
• Gastric emptying was assessed using ultrasound after ingestion of a standardized light meal (yogurt).
• Measurements of antral area were taken at intervals to calculate the fraction of gastric emptying at 90 minutes.

Main Results:

• Gastric emptying was significantly reduced in parturients compared to nonpregnant and pregnant controls.
• Parturients receiving epidural analgesia showed a significantly lower fraction of gastric emptying at 90 minutes compared to nonpregnant and pregnant controls.
• Interestingly, gastric emptying was even lower in parturients without labor analgesia compared to those with epidural analgesia.

Conclusions:

• Gastric emptying of a light meal is delayed in laboring women.
• Labor epidural analgesia does not appear to worsen, and may even facilitate, gastric emptying.
• Findings suggest that allowing laboring women to consume light meals should be reconsidered.