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Scheduled For C-section. Opinion On Water Consumption Before Surgery?

Posted on Tue, 11 Jun 2013

Question: Hi Doctor Raichle,
I have one more quick question. I have a planned C-section next week Wednesday and my doctor told me not to eat or drink anything for 12 hours before the surgery. I totally understand about the food but it's a bit strange to me that I cannot even drink water for the full 12 hours. My friend told me for her planned C-section, the requirement for the water was not to drink water only 4 hours before the surgery. Also, she ended up having full anaesthesia due to pain and was still ok. I would not go against my doctor's instructions but was wondering, maybe I will call the hospital and ask if there is any way to shorten the 12 hour period for water. What is your experience with that? Thanks

Answered by Dr. Timothy Raichle (2 hours later)

Thank you for the followup question.

While the typical generic answer to patients having surgery is nothing to eat or drink after midnight the night before surgery, this has certainly been modified over time. In our hospital it is nothing to eat for 8 hours and clear liquids up until 6 hours before surgery.

Certainly in pregnancy we are a bit more careful about reflux related issues and it is certainly considered reasonable to assume that 8 hours of nothing by mouth to be reasonable. I would definitely consider asking if you could talk with the Anesthesiologist for you case and ask specifically what they would like. I am guessing that their answer will be more reasonable than the generic answer of nothing for 12 hours.

I hope that this helps and goo luck!!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Timothy Raichle (3 minutes later)

Thanks Dr. Raichle, I just called the hospital and a triage nurse told me the same - clear fluids are ok up to 6 hrs before the surgery. I guess I have to check with the doctor.

If I was to do the full 12 hours of no water, as he wants, is this XXXXXXX for the baby to go through such dehydration? I know when I had the stomach flu 6 months ago they put me on IV right away because of the vomitting and the fact they were concerned with dehydration. So would you say that 12 hrs of dehydration is ok for the baby?

Answered by Dr. Timothy Raichle (37 hours later)

Thank you for the followup - I am sorry about the delay getting back to you!

I am going to imagine that what the triage nurse told you is also consistent with what any of the OB/GYN's would also say. Certainly it is never wrong to run it by your doctor, but these recommendations are pretty standard.

12 hours of no fluids would not hurt the baby. Sometimes when women are dehydrated due to illness, it can cause some uterine contractions, but in the setting of no illness, this is unlikely to be the case. It is far more of a risk of aspirating during the surgery if your stomach is not empty.

I hope that this hleps!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Timothy Raichle (33 minutes later)

Thanks Dr. Raichle, I have one more unrelated question and will ask it here since my doctor is not available till Monday. I have been having increased discharge, sometimes with reddish color and sometimes clear. Is there any chance it could be slow leak of amniotic fluid and if so, is it ok to wait till Wed when my C-section is? Unless it's risky, I preferred not to go to triage and wait there a few hours to get it checked out, especially considering there are so few days left to baby's birth. I had this increased leakage yesterday and the day before, today not so much yet...

If it's amniotic fluid slow leakage, is there anyway to recognize it? I have the Chemical strips for urine sugar testing and PH urine testing and i used them yesterday to test the discharge and it showed PH of less than 5.0 (i.e. the lowest on the strip, there is no lower one). I read somewhere that if it's amniotic fluid the PH should be around 7.00. But I don't know if this is good enough of a test.... Thanks

Answered by Dr. Timothy Raichle (27 minutes later)

I am certain that if you were to talk with your doctor and explain that you were having and increased watery discharge with possible blood tinging, that they would certainly send you to triage to get this checked out. If you are actually ruptured, then you need to be delivered now. This is very important to sort out. Perhaps there is another OB that can still see you in their clinic, but if not, then you need to go to triage.

There is absolutely no over-the-counter way to sort out leaking amniotic fluid from vaginal discharge / urine / etc.

Sorry, I know you want to avoid triage, but this is likely not going to be possible.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Timothy Raichle (7 minutes later)

Thanks Dr. Raichle, I guess I will go to triage then. Can this just be passing of the mucus plug though (or part of it), or normal discharge for someone 38 weeks pregnant? I.e. it does not mean there is necessarily a problem...right? Thanks

Answered by Dr. Timothy Raichle (33 minutes later)

The possibilities include:
1. Change in cervix / extrusion of mucous plug
2. Rupture of membranes
3. Normal vaginal discharge

Yes, in all likelihood you are not ruptured and you will be sent home. BUT, if you ARE ruptured, then it changes everything!! It is very important to sort out for the sake of the baby.

Good luck!!!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar