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Ranitidine as an antacid before elective Caesarean section.

D M McAuley, J Moore, W McCaughey

    Anaesthesia
    |February 1, 1983
    PubMed
    Summary
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    Ranitidine administered intravenously or orally during labor and Cesarean sections did not negatively impact maternal or neonatal outcomes. Fetal exposure to ranitidine was minimal, with low levels observed in newborns post-delivery.

    Area of Science:

    • Obstetrics and Gynecology
    • Pharmacology
    • Neonatal Medicine

    Background:

    • Maternal aspiration of gastric contents is a risk during anesthesia.
    • Ranitidine is a histamine H2-receptor antagonist used to reduce gastric acid production.

    Purpose of the Study:

    • To evaluate the safety and efficacy of ranitidine in pregnant women.
    • To assess the impact of ranitidine on uterine contractions, fetal heart rate, and neonatal well-being.
    • To determine ranitidine's pharmacokinetic profile during pregnancy.

    Main Methods:

    • Intravenous ranitidine (50 mg) administered to 20 women in labor.
    • Oral ranitidine (150 mg) given to 80 women undergoing elective Cesarean section.
    • Maternal and fetal ranitidine levels measured.

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  • Neonatal assessments included Apgar scores and neurobehavioral examinations.

    • Main Results:

    • No significant changes in uterine contractions or fetal heart rate observed with IV ranitidine.
    • Oral ranitidine significantly reduced gastric aspirate volume and increased gastric pH.
    • Fetal-maternal ranitidine ratios were low (0.9 IV, 0.38 oral) with minimal neonatal levels post-delivery.
    • No adverse neonatal outcomes were attributed to ranitidine in either group.

    Conclusions:

    • Ranitidine appears safe for maternal and neonatal use during labor and Cesarean delivery.
    • Oral ranitidine effectively reduces gastric acidity in parturients.
    • Minimal fetal exposure and no adverse neonatal effects suggest a favorable safety profile for ranitidine in pregnancy.