You might have read the previous post on Airway management in obstetric anesthesia.
this post is an extension to the previous one.
- Pulmonary aspiration is defined as the inhalation of foreign material below the level of the vocal cords and into the lower respiratory tract
- Pulmonary aspiration is the commonest cause of death in association with complications of airway management.
- Pregnant women are at increased risk of aspiration due to a number of factors including delayed gastric emptying.
- The factors increasing the risk of aspiration associated with pregnancy include the gravid uterus, progesterone-mediated lower oesophageal sphincter relaxation, lower gastric pH and delayed gastric empting during labour.
- Aspiration pneumonitis is called Mendelson’s syndrome in pregnancy and can have deleterious effects secondary to lower pH of gastric contents.
- Recent policies now recommend a light diet in established labour. It is not clear whether the change to policy on oral intake will impact on the frequency of maternal aspiration.
Here is an online video of approx 50 min which discusses the problem of aspiration in a pregnant patient.
Also added two presentations on aspiration pneumonitis .These are not from Obstetric anesthesia point of view per se but are still a good read.
Video on Aspiration in Obstetric Anesthesia
Two Presentations on Aspiration Pneumonitis from Medicine Perspective….
Regardless of the type of aspiration material, there is an acute inflammation in the lung characterised by neutrophil infiltration, alveolar haemorrhage, intra-alveolar and interstitial oedema, and impairment of alveolar fluid clearance. This is followed by a repair process characterised by scavenging of alveolar detritus by macrophages and proliferation of type II alveolar epithelial cells.
Aspiration Pneumonia medicine
Also look at our Obstetric Anesthesia section to read more articles on the subject.
We have a dedicated Airway management section . Also look for articles of your interest.