Legal abortion mortality and general anesthesia

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Public Health

Background:

• Legal abortion-related mortality reported to the Centers for Disease Control (CDC) showed an eightfold decline between 1972 and 1981.
• Despite the overall decline, the causes of mortality associated with legal abortions have shifted over time.

Purpose of the Study:

• To analyze the trends in causes of legal abortion-related deaths in the United States from 1972 to 1985.
• To identify specific risk factors and causes contributing to mortality from general anesthesia complications during legal abortions.

Main Methods:

• A retrospective review of all reported legal abortion-related deaths in the United States between 1972 and 1985.
• Statistical analysis to compare the proportion of deaths attributed to general anesthesia complications over different time periods and demographic groups.

Main Results:

• The absolute number of deaths from general anesthesia complications did not increase, but their proportion rose significantly from 7.7% (1972-1975) to 29.4% (1980-1985).
• Deaths from general anesthesia complications were disproportionately higher among Black and other racial groups, women undergoing first-trimester abortions, and those in the Northeast region.
• At least 23 of 27 anesthesia-related deaths were linked to hypoventilation and/or airway loss leading to hypoxia.

Conclusions:

• General anesthesia complications represent an increasing proportion of legal abortion-related deaths.
• Skilled airway management and proficiency in general anesthesia are crucial for providers administering anesthesia for abortions.
• Targeted interventions may be needed for specific demographic groups experiencing higher rates of anesthesia-related mortality during abortions.