(1055) The association of free fluid in the abdomen after cesarean delivery and postpartum pain

The primary outcome is to evaluate the correlation between free fluid in the abdomen postop after cesarean delivery and postpartum opioid use. Secondary outcomes are correlation between free fluid levels postop and postpartum pain scores, and whether cleaning of the paracolic gutters intraop affects free fluid levels postop. We utilize a modified FAST scan to evaluate levels of free fluid in the abdomen after cesarean delivery. 

Study Design:

This is a prospective observational study of women undergoing cesarean delivery for any indication (N=38). Patients are recruited and consented upon admission to labor and delivery or upon decision for C-section. Women are excluded from the study if they have a vaginal delivery followed by any surgical procedure, or if they are under 18 years. The sonographer of this study was trained and validated by a registered diagnostic medical sonographer. Patients undergo a modified FAST scan within 2 hours postop and again 36-48 hours postop. 

Results: In this small cohort, the presence of free fluid did not correlate with the amount of opioid use while inpatient (immediate postop p=.319; delayed postop p=.166) or postpartum pain scores at 2, 24, or 48 hours postop (immediate postop p=.639, .981, .765 respectively; delayed postop p=.631, .459, .878 respectively). Cleaning of the paracolic gutters was not significantly associated with the presence of free fluid in the abdomen (immediate postop p=.728; delayed postop p=.449). 

Conclusion:

In our initial study population, free fluid in the abdomen detected by FAST scan does not correlate with postpartum opioid use or pain scores. Cleaning of the paracolic gutters is not associated with the amount of free fluid detected on FAST scan. The main strength of this study is that this is the first study to examine the relationship between free fluid in the abdomen postop and postpartum opioid use and pain scores. The main limitation of this study is the small sample size. Additionally, documentation of postpartum pain scores and operative report documentation on cleaning of the paracolic gutters is inconsistent in the EMR.