ELECTIVE CAESAREAN AND ELECTIVE SURGERY DURING PREGNANCY

• To provide guidance on measures to minimise the incidence and consequences of gastric aspiration in peri-operative pregnant women. BACKGROUND In pregnancy, anatomical and physiological changes to the gastrointestinal system predispose women to an increased incidence of gastric reflux and regurgitation. This is most apparent beyond 20 weeks gestation. Gastric reflux and regurgitation are risk factors for pulmonary aspiration during general anaesthesia. KEY POINTS • Preventative strategies aim to reduce the volume and pH of the stomach contents.. MANAGEMENT For elective caesarean / surgery fasting requirements: 6 hours for food, 2 hours for clear fluids. For more detailed fasting guidelines see: Clinical Guidelines Section E (Anaesthetics): Fasting guidelines. All usual anti-reflux medications should be continued throughout the peri-operative period, including when in labour and when fasting. Patients with gastric bands should have these deflated well in advance of planned surgery