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ASPIRATION OF VOMITUS DURING OBSTETRIC ANESTHESIA

JAMA. 1951;146(13):1236. doi:10.1001/jama.1951.03670130058015.
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In a recent article Merrill and Hingson 1 call attention to the hazard of aspiration of vomitus during anesthesia in obstetrics. Questionnaires replied to by 183 hospitals reporting a total of 2,503,921 births in the past five years revealed 59 maternal deaths during this period from such aspiration during induction or during emergence from anesthesia. From these figures, the authors estimate that in the United States there must be at least 100 maternal deaths per year from this cause. This would represent some 2% of the total maternal mortality.

Factors that predispose to vomiting during obstetrical anesthesia include a delay in the emptying time of the stomach during labor; a predisposition to anoxia due to limitations of respiratory exchange caused by the enlarged uterus; the light anesthesia that is necessary to maintain uterine contractibility and the cooperation of the patient, but which renders the vomiting center hypersensitive; and the difficulty

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