Friday, October 30, 2015
Women undergoing labour are generally advised fasting as they run the risk of aspirating fluid in the lungs leading to pneumonia. The risk was higher with older anaesthesia administration techniques that involved placing a mask over the nose and mouth along with a tube placed in the windpipe for breathing. However, with the advent of improved anaesthesia care and the use of epidurals and spinal blocks, healthy women can now partake a light meal during labour and reap benefits by doing so, finds a study.
These results will be presented at the 2015 ANESTHESIOLOGY® annual meeting in San Diego. The researchers of the study looked at labour and delivery data from the American Society of Anesthesiology's Closed Claims Project database between 2005 and 2013. They found that the risks associated with aspiration were negligible with only one complicated case reporting it. Analysis of data from United Kingdom showed no deaths due to aspiration between 2000 and 2005, compared to 1.5 cases per 1,000 during the 1940s.
The researchers even explained the reason why a light meal may help a woman in labour. They looked at 385 studies published in 1990 or later and found the caloric and energy requirements of a woman in labour to be similar to a marathon runner. Without adequate nutrition, a woman’s body will dig into the fat depot for energy. This could increase the acidity of blood in both mother and infant, potentially reducing uterine contractions, prolonging labour and lowering health scores in newborns.
Furthermore, fasting could cause emotional stress, diverting blood away from the placenta and uterus and prolonging the labour process. This could contribute to increased distress in the foetus. A light meal could mean fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water. Although most women might lose appetite during active labour, they could continue sipping water or clear juices.
However, the researchers offer a word of caution for women with pregnancy related complications. Certain conditions such as eclampsia, pre-eclampsia, obesity and the use of opioids to manage labour pain (known to delay stomach emptying) could increase the risk of aspiration and therefore consult their physician.
"Our findings suggest a change in practice makes sense. Physician anaesthesiologists and obstetricians should work together to assess each patient individually. Those they determine are at low risk for aspiration can likely eat a light meal during labour. This gives expectant mothers more choices in their birthing experience and prevents them from being calorie deficient, helping to provide energy during labour," concluded the researchers.
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