Measure Abbreviation
GA 01-OB
Data Collection Method

This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data.  This measure is explicitly not based on provider self-attestation.

 

Measure Type
Outcome
Description

Percentage of cesarean delivery cases where general anesthesia was used

Measure Time Period

Anesthesia Start to Anesthesia End 

 

Inclusions
  • Cesarean Delivery cases as determined by the “Obstetric Anesthesia Type” Phenotype. Phenotype results included:
    • Cesarean Delivery
    • Conversion (Cesarean Delivery Portion)
    • Conversion (Labor epidural and cesarean delivery combined)
Exclusions
Success

Cesarean delivery completed without use of general anesthesia

Other Measure Build Details

Measure Start Time: Anesthesia Start

Measure End Time: Anesthesia End

  • Use of general anesthesia is determined by the ‘Anesthesia Technique: General’ phenotype
  • Cases where ‘measure end’ precedes ‘measure start’ will be excluded from the measure
Responsible Provider

n/a, departmental only measure

Threshold
n/a, Informational only
MPOG Concept IDs Required

See concepts included in the ‘Obstetric Anesthesia Type’ phenotype and ‘Anesthesia Technique: General’ phenotypes

Rationale

General anesthesia is used in roughly 5% of elective cesarean deliveries and 14-20% of emergent cesarean deliveries.1,2 Mothers who receive neuraxial anesthesia report less pain on the day of surgery, show less gastrointestinal stasis, fevers, and coughing on post op day 2, and show earlier mobility and breastfeeding onset than those who receive general anesthesia.3  Mothers who receive general anesthesia during cesarean delivery may also be at increased risk of severe postpartum depression as compared to those who receive neuraxial anesthesia.4

Risk Adjustment

n/a

References
  1. an, and Brenda A. Bucklin. 2016. “Obstetric Anesthesia Workforce Survey: A 30-Year Update.” Anesthesia and Analgesia 122 (6): 1939–46.
  2. Juang, Jeremy, Rodney A. Gabriel, Richard P. Dutton, Arvind Palanisamy, and Richard D. Urman. 2017. “Choice of Anesthesia for Cesarean Delivery: An Analysis of the National Anesthesia Clinical Outcomes Registry.” Anesthesia and Analgesia 124 (6): 1914–17.
  3. Morgan, B. M., J. M. Aulakh, J. P. Barker, P. W. Reginald, T. Goroszeniuk, and A. Trojanowski. 1984. “Anaesthetic Morbidity Following Caesarean Section under Epidural or General Anaesthesia.” The Lancet 1 (8372): 328–30.
  4. Guglielminotti, Jean, and Guohua Li. 2020. “Exposure to General Anesthesia for Cesarean Delivery and Odds of Severe Postpartum Depression Requiring Hospitalization.” Anesthesia and Analgesia 131 (5): 1421–29.