Surveillance of maternal aspiration in pregnancy

Summary

Pulmonary aspiration is the inhalation of foreign material into the lower respiratory tract, which can lead to severe maternal morbidity including Acute Respiratory Distress Syndrome (ARDS) and associated organ failure. Severe cases of aspiration are known to cause maternal death. The risk of gastric content inhalation is increased by both emergency general anaesthesia and pregnancy; despite this, there are no epidemiological data for the UK on maternal pulmonary aspiration in pregnancy. Furthermore, information regarding the characteristics of affected women and the management of aspiration in pregnancy, as well as the subsequent maternal, fetal and neonatal outcomes, is sparse.

Recent amendments to national guidelines no longer restrict maternal oral intake during established labour and this has the potential to increase the incidence of pulmonary aspiration in pregnancy, as highlighted by several recent case-reports. Thus further study of maternal pulmonary aspiration is currently of particular importance.

The objectives of this study are to conduct a national descriptive study using the UK Obstetric Surveillance System (UKOSS) over a 24-month period to identify all cases of maternal pulmonary aspiration, and to use these data to describe the characteristics of affected women, management of the condition and the subsequent maternal, fetal and neonatal outcomes. The results of this study will be used to inform current guidelines on oral intake during labour, as well guidance on the prevention and management of maternal pulmonary aspiration in pregnancy.