Aspiration risk assessment for postpartum tubal ligation using gastric ultrasound: a single-center prospective...

The American College of Obstetricians and Gynecologists prioritizes postpartum tubal ligation as a non-elective procedureand recommends it be performed urgently. This study assessed postpartum aspiration risk using gastric ultrasound.

In this prospective study, women underwent gastric ultrasound one hour after vaginal delivery to assess aspiration risk. High aspiration risk was defined as solid/thick contents on qualitative ultrasound in either position and/or clear fluid with a calculated gastric volume ≥1.5 mL/kg on quantitative assessment in the right lateral decubitus position. Ultrasound-based risk classification was compared with aspiration risk based on American Society of Anesthesiologists' time-based fasting criteria.

Gastric ultrasound was performed in 54 women. Median time since last clear liquid intake was 2.0 h, and since last solid intake was 15.2 h. High aspiration risk was identified in 25 women (46.3%). Fifteen women (27.8%) met time-based fasting criteria but had high-risk gastric contents on ultrasound.

Immediate postpartum tubal ligation may pose significant aspiration risks. If postpartum tubal ligation is being considered soon after delivery, aspiration risk should be assessed with gastric ultrasound, as time-based fasting criteria may not reliably reflect gastric contents in the early postpartum period.