Atrash H K, Cheek T G, Hogue C J
Division of Reproductive Health, Centers for Disease Control, Atlanta, Georgia.
Am J Obstet Gynecol. 1988 Feb;158(2):420-4. doi: 10.1016/0002-9378(88)90169-x.
Legal abortion-related mortality as reported to the Centers for Disease Control declined eightfold between 1972 and 1981. However, the causes of legal abortion mortality have changed over time. We reviewed all legal abortion-related deaths that occurred between 1972 and 1985 in the United States. We found that, although the absolute number of legal abortion-related deaths caused by general anesthesia complications did not increase, the proportion of such deaths increased significantly, from 7.7% between 1972 and 1975 to 29.4% between 1980 and 1985. Women who died of general anesthesia complications did not differ by age, presence of preexisting medical conditions, or type of facility from women who died of other causes. However, the proportion of deaths from general anesthesia complications was significantly higher among women of black and other races, women obtaining abortions during the first trimester, and women obtaining abortions in the Northeast. Our results indicate that at least 23 of the 27 deaths were due to hypoventilation and/or loss of airway resulting in hypoxia. Persons administering general anesthesia for abortion must be skilled in airway management as well as the provision of general anesthesia.
向疾病控制中心报告的与合法堕胎相关的死亡率在1972年至1981年间下降了八倍。然而，合法堕胎死亡的原因随时间发生了变化。我们回顾了1972年至1985年间在美国发生的所有与合法堕胎相关的死亡案例。我们发现，虽然因全身麻醉并发症导致的与合法堕胎相关的死亡绝对数量没有增加，但此类死亡的比例显著上升，从1972年至1975年间的7.7%升至1980年至1985年间的29.4%。死于全身麻醉并发症的女性在年龄、是否存在既往疾病或医疗机构类型方面与死于其他原因的女性并无差异。然而，黑人及其他种族的女性、在孕早期进行堕胎的女性以及在东北部进行堕胎的女性中，因全身麻醉并发症导致的死亡比例显著更高。我们的结果表明，27例死亡中至少有23例是由于通气不足和/或气道丧失导致缺氧。为堕胎实施全身麻醉的人员必须熟练掌握气道管理以及全身麻醉的提供。
