Oral Intake and Antacid Prophylaxis

Selected Guideline Examples	Date
Wythenshawe Hospital	June 2021
Rosie Hospital, Cambridge	August 2020
North Bristol	February 2021
Lewisham and Greenwich	June 2021
Bolton	March 2019

We Liked	“Think drink” for elective CS list Use of tables for clarity covering fasting requirements for low risk labour/ high risk labour/ elective surgery and antacid prophylaxis for same plus Cat 1/2/3 CS Table comparing speed of onset/ duration of action/ safety in breastfeeding of antacids commonly used Recommendation to continue antacid prophylaxis until 3rd stage of labour complete and no other surgical treatment required Recommendation to keep women fasted in recovery postoperatively if complicated surgery and/or potential to return to theatre Emphasis that antacid prophylaxis is the responsibility of all doctors and midwives
Comments	Ranitidine was recalled in October 2019 due to concerns regarding some preparations containing carcinogens. Not all guidelines have been updated to acknowledge a change in practice, with most units now using omeprazole for antacid prophylaxis. Oral and intravenous preparations of omeprazole should be available on the delivery suite.