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Risk Factors for Severe Secondary Postpartum Hemorrhages: A Historical Cohort Study

indicating fluid seen in the right lateral decubitus position, or 2, indicating fluid seen in both the lateral decubitus and supine positions. Still images from the patient in the right lateral decubitus position were used to determine the crosssectional area of the antrum. Of the 103 women in the cohort, gastric contents were graded as 0 in 53 patients and 1 in 49; there was only 1 who was graded 2 despite fasting [1/103=0.97%; 95% confidence intervals (CI), 0.05%-6.06%]. Ninety-five percent of the women had an antral cross-sectional area of r9.6 cm (95% CI, 8.6-10.3 cm) in the right lateral decubitus position, corresponding to an estimated gastric volume of r117mL (95% CI, 108-127mL) or r1.5mL/kg (95% CI, 1.3-1.7mL/kg). There was a positive correlation between the patient’s antrum cross-sectional area and the patient’s age, weight, and body mass index. The results of this study showed that an antral crosssectional area of 10.3 cm in the right lateral decubitus position was the upper limit of normal findings in fasted pregnant women at term, in contradiction to lower values that have been suggested in other studies. The 3-point grading system was also validated, as the majority of the women were determined to have little to no gastric fluid and the results were similar to a nonpregnant patient population. This study confirmed that bedside ultrasonography can be beneficial for real-time patient assessment.