Obstetric Anesthesia Services Profile in Cesarean Section in Indonesian Population: A Prospective, Observational, Multicenter Study

Abstract

Background: All obstetrics or pregnant patients potentially require anesthesia during their delivery, both planned and emergency. The rate of cesarean deliveries in Indonesia has also increased from 9.8% to 17.6%. This study was conducted to provide a profile of anesthesia services in obstetric patients in Indonesian population. Materials and Methods: This observational prospective multicenter study was conducted from March to June 2022 in 67 hospitals in Indonesia. A total of 1731 subjects were enrolled. The study population consisted of patients who received obstetric anesthesia services during cesarean section. Data collection was conducted via the REDCap application. Results: A total of 1731 subjects were included in this study. Most cases were emergency surgeries (66.44%), with an American Society of Anesthesiologists classification of ASA II with emergency situation (53.96%). Spinal anesthesia was the most frequent technique (96.42%), although 1.16% of subjects had a conversion of anesthesia technique. The most common complication during the surgery, in the recovery room, and in the ward was hypotension (8.55%, 1.50%, and 0.58%, respectively), and the maternal mortality rate was 0.29%, with some identified causes being prolonged shock. A total of 120 (6.93%) subjects experienced postoperative care in the intensive care unit, whereas the remaining 1511 (93.17%) subjects did not. Conclusion: Anesthesia services in this study showed proper and representative results for obstetrics services in Indonesia. Our study demonstrated that single shot spinal anesthesia is the most commonly preferred mode of anesthesia for both elective and emergency cesarean delivery cases. However, there is still room for improvement in the anesthesia field, which should be continuously evaluated.

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