The Incidence of Maternal Hypoglycaemia Associated with Prolonged Fasting Before Elective Caesarean Section: A Retrospective Study from a Tertiary Care Centre

Abstract

Background: Preoperative fasting before elective caesarean section is routinely practiced to reduce the risk of aspiration during anaesthesia. However, prolonged fasting in pregnant women may predispose to maternal hypoglycaemia, which can adversely affect both maternal well-being and fetal outcomes.

Objectives: To determine the incidence of maternal hypoglycaemia associated with prolonged preoperative fasting before elective caesarean section and to assess its association with duration of fasting and maternal clinical characteristics.

Methods: A retrospective observational study was conducted at Patna Medical College and Hospital (PMCH), Patna, over a one-year period (January 2025–December 2025). Records of 100 women who underwent elective caesarean section were reviewed. Fasting duration, preoperative random blood glucose levels, and maternal characteristics were analyzed. Maternal hypoglycaemia was defined as blood glucose <70 mg/dL. Statistical analysis was performed using appropriate tests, with p <0.05 considered significant.

Results: The incidence of maternal hypoglycaemia was 28%. Prolonged fasting duration (>10 hours) was significantly associated with hypoglycaemia (p <0.001). Mean blood glucose levels decreased progressively with increasing fasting duration.

Conclusion: Prolonged preoperative fasting before elective caesarean section is significantly associated with maternal hypoglycaemia. Revisiting fasting protocols in obstetric practice may help reduce preventable metabolic complications.