Decision‐to‐delivery interval in pregnant women with intrapartum non‐reassuring fetal heart rate patterns

Boriboonhirunsarn, Dittakarn; Watananirun, Kanokwaroon; Sompagdee, Nalat

doi:10.1111/jep.12613

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…Previous studies reported an improvement in the time to delivery by implementing a multidisciplinary protocol, a team training with more effective communication and an obstetric care process [ 19 20 ]. The results of this study also showed some improvement in the care process among women with non-reassuring FHR, compared to a recent report from the same institution [ 14 ]. Achievement of 30-minute goal increased from 6.6% to 18.8% and rate of delivery in ≤75 minutes increased from 69.5% to 75%.…”

Section: Discussionsupporting

confidence: 62%

“…In Thailand, there is limited information regarding the time interval for emergency cesarean delivery and no specific recommendation has been adopted. A recent report in Thailand showed that only 6.6% of women with non-reassuring fetal heart rate (FHR) pattern achieved the 30-minute goal for cesarean delivery with a median time of 56 minutes [ 14 ]. However, such study focused on only women with non-reassuring FHR, but not on women with other indications for emergency cesarean delivery.…”

Section: Introductionmentioning

confidence: 99%

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Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand

2018

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ObjectiveTo determine the decision-to-delivery interval (DDI) in emergency cesarean delivery and associated factors.MethodsA total of 431 pregnant women who were indicated for emergency cesarean delivery were included. Clinical information and timing of process after decision until delivery and pregnancy outcomes were evaluated.ResultsMean age was 30 years, and 59.4% were nulliparous. Mean gestational age at delivery was 37.9 weeks. The decision was made during normal office hour in 33.2%. Median decision-to-operating room interval, decision-to-incision interval, and DDIs were 45, 70, and 82 minutes, respectively. Only 3.5% of patients had DDI ≤30 minutes, while 52.0% had DDI >75 minutes. During after office hours, every time interval was significantly shorter and 4.9% had DDI ≤30 minutes compared to 0.7% in normal office hours (P=0.001). Compared to other indications, time intervals were significantly shorter in those with non-reassuring fetal heart rate (FHR), and DDI ≤30 minutes was achieved in 18.8% vs. 0.8% (P<0.001). Shortest DDI was observed among those with non-reassuring FHR during after office hours. Neonatal outcomes were comparable between different DDIs.ConclusionOnly 3.5% of emergency cesarean delivery had a DDI ≤30 minutes (median 82 minutes). Significant shorter time intervals were observed in those with non-reassuring FHR during after office hours.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand

2018

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“…Neonatal outcomes were comparable irrespective of DDI. 21 Our data suggest formal inclusion of MOFR into EFM interpretation (FRI) seems to allow for earlier and more accurate prediction of fetal intolerance to labor requiring EOD when compared to currently utilized interpretation and management methodology. In an earlier study, we found that ACOG category III appears too far to the right on the curve to be helpful for either timely identifying or preventing serious fetal injury or EOD.…”

Section: Discussionmentioning

confidence: 79%

“…Neonatal outcomes were comparable irrespective of DDI. 21…”

Section: Discussionmentioning

confidence: 99%

Reengineering Electronic Fetal Monitoring Interpretation: Using the Fetal Reserve Index to Anticipate the Need for Emergent Operative Delivery

Eden

Evans

et al. 2018

Reprod. Sci.

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“…Yakasai et al, 15 found that despite a delay of > 30min in 87% cases, about 83.4 % of the cases had a good fetomaternal outcome. Boriboonhirunsarn et al, 16 found a DDI of >3 0 min for Category 1 CS in 93.4% of cases and noted no significant difference among groups relative to birth weight, birth asphyxia and NICU admission.…”

Section: Discussionmentioning

confidence: 94%

Decision to delivery interval in emergency cesarean section and its association with perinatal outcome

et al. 2021

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Background: Decision to delivery [DDI] interval is the time interval between decision for caesarean section [CS] and delivery of baby. The ideal DDI for emergency CS is not known; there is controversy over the best DDI to avoid preventable perinatal morbidity and mortality. Aims and Objectives: This study was conducted to find out the DDI we could achieve for Category-1 and Category-2 CS and evaluate our findings against the recommendations by National Institute for Clinical Excellence [NICE]. We also studied the association of DDI with perinatal outcome and explored the reasons for prolongation of DDI. Materials and Methods: This was a prospective study conducted over a period of 6 months. All women who underwent CS and meeting the inclusion criteria were recruited for the study. DDI was calculated as the time interval between decision making and delivery of baby, in minutes [min]. Data was collected for maternal socio-demographic variables, CS indication and complications and perinatal outcome. Analysis was done using SPSS version 21.0. Results: Ninety out of one hundred eighty-one CS was evaluated. Cases were grouped as Group I [including cases where we could achieve the recommended DDI] and Group II [including cases where we could not achieve the recommended DDI]. The average DDI was 55.04 min for category- 1 and 55.13 for category-2 CS. For Category-1 CS, all the cases qualified for entry into Group II because we could not achieve a DDI of 30 min. For Category-2 CS there were 22 cases in Group I and 14 cases in Group II. There was no difference in perinatal outcome between the groups. Conclusion: It was not feasible to achieve the 30 min DDI for Category-1 CS in the present study. The DDI of 30-75 min for Category-2 could be achieved in 61.11% cases. The most common reason for failure to achieve the recommended DDI was related to issues with anaesthesia in the pre-operative room as well as inside the theatre in the pre-induction phase. Delay in category-2 CS was not associated with poor perinatal outcome.

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Decision‐to‐delivery interval in pregnant women with intrapartum non‐reassuring fetal heart rate patterns

Abstract: Only 6.6% of women with non-reassuring FHR achieved the 30-minute goal for caesarean delivery (median 56 minutes). Better performance was observed among patients in FHR category 3 regardless of diagnosis time, with 41.2% of these patients having a DDI of <30 minutes.

Cited by 12 publications

References 30 publications

Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand

Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand

Reengineering Electronic Fetal Monitoring Interpretation: Using the Fetal Reserve Index to Anticipate the Need for Emergent Operative Delivery

Decision to delivery interval in emergency cesarean section and its association with perinatal outcome

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