PREGNANT

Pregnant12

Legend: C: colon; F: foetus; L: liver; P: pancreas; Pla: placenta; U: uterus wall; Yellow arrows: empty antrum.

  • Identification of the antrum can be more difficult in pregnant patients due to:
    • The gravid uterus (and moving fetus).
    • The stomach is displaced more cephalad and to the right compared with non-pregnant subjects.
    • Fast and shallow breathing
    • Hyperdynamic circulation
    • More difficult epigastric probe placement (steep angle between xyphoid and abdomen)
  • Visualization can be optimized through:
    • Semi-recumbent and right lateral decubitus positions.
    • Slight manual displacement of the gravid uterus.
    • Ask the patient to take a slow deep breath and hold her breath at end-expiration.
  • A mathematical model to estimate volume in pregnant women is currently under investigation.
  • Qualitative ultrasound assessment accurately determines the type of gastric content (empty, clear fluids, or solid). The sensitivity of the test is highest for solid vs. fluid or empty states.
  • Non-laboring fasting women at term (e.g. elective C-sections) have similar baseline gastric volume (and antral grade distribution) to the non-pregnant adult population.

back to the top

Pregnant34

Legend: Ao: aorta; F: foetus; L: liver; P: pancreas; Pla: placenta; U: uterus wall; Yellow arrows: empty antrum.

fluidfilledantrumpregnant

Legend: F: foetus; L: liver; Yellow arrows: fluid filled antrum.