Frequency of adherence to obstetric anesthesia best practices for cesarean delivery: A multicenter retrospective cohort analysis
Authors' conclusion
Among our large cohort of CD cases, overall adherence to guideline-supported best practices was variable, with post-spinal vasopressor infusions being the lowest and avoidance of GA being the highest.
Study context
- Population
- Cesarean deliveries in women aged 15–44, Multicenter Perioperative Outcomes Group (MPOG) database, 2015–2022
- Participants
- 289,047 cesarean delivery (CD) cases
- Outcome
- Rate of adherence to best practice guidelines for CD
Methodological detailsmulticentre, observational, MPOG database
- Multicentre
- Observational
- MPOG database
Main finding
As reported in the abstract
Adherence to best practices
- Timely antibiotic administration
- 86.2% (99% CI 86-86.3%)
- Post-spinal SBP maintenance >90 mmHg
- 96.7% (99% CI 96.6-96.8%)
- Avoidance of general anesthesia (GA)
- 97.0% (99% CI 96.9-97.0%)
- Prevention of perioperative hypothermia
- 56.7% (99% CI 56.5-56.9%)
- Low-dose neuraxial morphine
- 74.2% (99% CI 74.0-74.5%)
- Post-spinal vasopressor infusion
- 55.4% (99% CI 55.1-55.8%)
- ≥ 25-gauge spinal needle
- 89.0% (99% CI 88.6-89.4%)
Observational data: associations, not effects.
Further findings
Factors associated with poorer adherence
- Poorer adherence correlated with ASA Physical Status ≥ 4 (patient), evening or overnight CD (case), and absence of obstetric fellowship or "Center of Excellence" status (institution)
Original publication
Frequency of adherence to obstetric anesthesia best practices for cesarean delivery: A multicenter retrospective cohort analysis. Anesthesiology. Published 12 August 2026. doi:10.
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