Acute gastric aspiration: prevention and treatment

Pulmonary aspiration of gastric contents is a leading cause of maternal morbidity and mortality for patients during labor. The risk is increased in those women who require obstetric surgery and general anesthesia. Furthermore, gastric aspiration is believed to be largely preventable. Care providers can reduce the risk by limiting oral intake during labor and assuming that all parturients have a full stomach. Conduction anesthesia should be encouraged over general anesthesia. Having a skilled anesthesiologist available is optimal. Prophylactic use of antacids, H2 receptor antagonists, and/or the use of dopamine antagonists should be administered before obstetric surgery to raise the pH and decrease the volume of gastric contents. Should aspiration occur, prompt recognition, treatment, and monitoring will improve outcome.