Ultrasound examination of the antrum to predict gastric content volume in the third trimester of pregnancy as assessed by MRI

Abstract

ANSM Register N°2015-A00800-49.

Using a composite ultrasound scale to assess gastric contents

“…Nevertheless, the mathematical model described by Arzola et al correlates highly with the mathematical model incorporating only the value of the antral area measured in the semirecumbent right-lateral position that we also described in our study, with R² = 0.73 [1,2]. The correlation coefficient between calculated volumes according to each model is r = 0.98 (95%CI: 0.95-0.99, and p < 0.0001) for values of antral area ranging from 300 to 1500 mm² that correspond to values usually measured in the semirecumbent rightlateral position (Fig.…”

“…This high correlation between both models suggests that the method applied by Arzola et al [1], and also previously by Perlas et al [3] and Zieleskiewicz et al [4] to assess the relationship between the antral area and the gastric fluid volume, was appropriate. However, Bland-Altman analysis shows a systematic underestimation of 23 ml when using the model by Arzola et al [1] compared with our model [2]. This bias may probably be related to the inclusion of 33 women (55%) with a grade-1 antrum and only 27 women (45%) with a grade-0 antrum before the ingestion of clear fluids in the study by Arzola et al [1].…”

“…In fact, Perlas et al [5] previously showed that a quarter of adult patients with grade-1 antrum had gastric fluid volume > 1.5 ml.kg À1 . In our previous study, we were able to confirm that three out of nine pregnant women (33%) with grade-1 antrum had MRI-measured gastric fluid volume > 1.5 ml.kg À1 [2].…”

“…This technique allows accurate and reliable measurement of meal volume, with high intra-rater and interobserver reliability. We found that the best mathematical model incorporated the antral area measured in both the semirecumbent position and the semirecumbent right-lateral decubitus position to predict the gastric content volume, with R² = 0.76 [2].…”

“…We recently assessed the relationship between the antral cross-sectional area (measured in the semirecumbent position and in the semirecumbent right-lateral position) and gastric content volume in women in the third trimester of pregnancy, with using magnetic resonance imaging (MRI) to calculate the volume of gastric content [2]. This technique allows accurate and reliable measurement of meal volume, with high intra-rater and interobserver reliability.…”