Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman

Tashfeen, Kaukab; Patel, Malini; Hamdi, İlham; Al-Busaidi, Ibrahim H.; Al-Yarubi, Mansour N.

doi:10.18295/squmj.2016.17.01.008

Cited by 26 publications

(19 citation statements)

References 12 publications

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“…The difference might be due to sample size. Another study done in Oman concluded that a DDI below 30 min was achieved in 23.8% of category-1 emergency C/S [22] which is comparable with the current study. On the other hand, a study done in Benin teaching hospital has showed that a DDI below 30 min was achieved in only 5.7% of emergency C/S and the mean ± SD of DDI was 106.3 ± 79.5 min [23].…”

Section: Discussionsupporting

confidence: 90%

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study

Temesgen

Gebregzi

Kasahun

et al. 2020

BMC Pregnancy Childbirth

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Background: Category-1 emergency caesarean section delivery is the commonly performed surgical procedure in pregnant women associated with significant mortality and morbidity both in the mother and fetus. The decision to delivery time interval is recommended to be less than 30 min by the Royal College of Obstetricians and Gynecologists as well as the American College of Obstetricians and Gynecologists. This study was designed to evaluate the decision to delivery time interval and its effect on feto-maternal outcomes and the associated factors during category-1 emergency caesarean section deliveries. Method: A prospective observational cohort study was conducted from March to May 2018 at the University of Gondar Comprehensive Specialized Hospital obstetrics Operation Theater and postnatal ward. A total of 163 clients who were undergone category-1 emergency caesarean section were included in this study. Statistical analysis was performed using SPSS version 20 (IBM Corporate). Bivariate and multivariate logistic regression with a 95% confidence interval was used to determine the association of decision to delivery time interval with predictor variables and feto-maternal outcomes. Results: Only 19.6% of women had a decision to delivery time interval below 30 min. The average decision to delivery time interval was 42 ± 21.4 min, the average time from the decision of category-1 emergency caesarean section arrival to the operation theater was 21.58 ± 19.76 min and from theater to delivery of anesthesia was 11.5 ± 3.6 min. Factors that were associated with prolonged decision to delivery time interval were: time taken to collect surgical materials (AOR = 13.76, CI = 1.12-168.7), time taken from decision and arrival to the operation theater (AOR = 0.75, CI = 0.17-3.25) and time taken from arrival at the operation theater to the immediate start of skin incision (AOR = 0.43, CI = 0.28-0.65). Conclusion: Delivery was not achieved within the recommended time interval in the majority of category-1 emergency caesarean sections. The average decision to delivery time interval was longer than the recommended time but it did not affect feto-maternal outcomes.

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Section: Discussionsupporting

confidence: 90%

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study

Temesgen

Gebregzi

Kasahun

et al. 2020

BMC Pregnancy Childbirth

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“…In Oman and Ethiopia for instance the rates are around 20-25%. 11,12 whereas in Hong Kong and Singapore rates as high as 80-90% are reported. 13,14 In order to ensure only 'genuine' category 1 cesarean sections were included, case files were reviewed to ensure the indication warranted a category 1 procedure.…”

Section: Discussionmentioning

confidence: 98%

Category 1 cesarean section decision to delivery interval: the causes of delay and impact on neonatal outcomes

Maducolil¹,

Ajmal²,

Alzebdeh³

et al. 2021

IPCB

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Objectives: The introduction of cesarean section categorization and recommendations on decision to delivery interval was a major step forward towards standardizing clinical response to obstetric emergencies. The recommended decision to delivery interval (DDI) for category 1 cesarean sections is 30 minutes, however there is a balance to be struck to ensure that reducing fetal hypoxic risk is not at the expense of increasing maternal and fetal morbidity. The aim of the study was to review category 1 cesarean sections, focusing on reasons for delays and neonatal outcomes. Design: The study was conducted as a quality improvement initiative to review the performance of the institution in managing women delivered as category 1 cesarean section between January 2020 and August 2020. Methods: The data was extracted from the operating theatre log book and patient electronic records (Cerner system) and analyzed using SPSS statistics package. Results: There were 577 cases of category 1 Cesarean section undertaken during the study period. The recommended DDI of 30 minutes was achieved in 385/577 (67%) of cases but was exceeded in 192/577 (33%) of cases. The most common indication of category 1 cesarean section was fetal distress (58%). It was noted that significantly more women (88.8%) in the <30-minute group had the decision taken in the labor ward, which is in close proximity to the obstetric theatre. Significantly more women in the <30-minute group had epidural or general anesthesia. Significant delays in the preparation time, transfer time, anesthesia time and delivery time were noted in the >30-minute group. The neonates in the <30-minute group had significantly lower pH and base excess measurements at birth however fewer were admitted to the neonatal intensive care unit. Conclusion: This study has demonstrated that only two thirds of category 1 cesarean deliveries are performed within the 30-minute recommendation. The delays were evident at every stage of the process of performing the cesarean. There are some factors which are not modifiable such as non labor ward transfers. Continued monitoring of category 1 cesarean outcomes is recommended.

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“… 19 But the result was lower than a study conducted in Oman showing that in 23.8% of emergency CS deliveries, a DDI less than 30 minutes was achieved. 20 …”

Section: Discussionmentioning

confidence: 99%

Decision to Delivery Interval, Fetal Outcomes and Its Factors Among Emergency Caesarean Section Deliveries at South Gondar Zone Hospitals, Northwest Ethiopia: Retrospective Cross-Sectional Study, 2020

Ayele¹,

Kassa²,

Mihretie³

et al. 2021

IJWH

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Purpose Although its fetal outcomes and practicality are unclear time interval between decision-to-delivery ≤30 minutes in emergency caesarean section (CS) is the internationally accepted standard of practice. This study aimed to determine whether a decision to delivery interval (DDI) of approximately 30 minutes was achieved in daily practice, its fetal outcomes, and associated factors among emergency caesarean section delivery at South Gondar Zone Hospitals, Northwest Ethiopia. Patients and Methods Retrospective cross-sectional study was carried out from August 1–30/2020 among emergency caesarean sections. Information was collected from the birth register book and individual files of standardized facility booking forms. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. A bivariable and multivariable logistic regression analysis was conducted and a significant association was recorded at p<0.05. Results Only 17.5% of parturients attained a decision-to-delivery interval ≤30 minutes. The average median of decision to delivery interval was 54 minutes with interquartile range (IQR) of 48–80 minutes. Time taken to collect material with Adjusted odds ratio (AOR=10.3, 95% CI 5.87–45.7), time of decision (AOR=0.32, 95% CI, 0.15–0.67), and time taken from decision to delivery to delivery of anesthesia (AOR=4.74, 95% CI, 1.30–17.3) were the predictors of prolonged delivery time interval. Significant fetal adverse outcomes were not observed in a decision to delivery interval higher than 30 minutes. Conclusion In most cases, delivery was not completed within the prescribed ≤30-minutes interval, particularly in developing countries with infrastructural challenges, however, fetal outcomes were not directly correlated. Despite lack of substantial linkage between the delivery time declaration and fetal events, an unreasonable gap from the decision-making to birth of the child is not appropriate and should be discouraged.

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Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman

Cited by 26 publications

References 12 publications

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study

Category 1 cesarean section decision to delivery interval: the causes of delay and impact on neonatal outcomes

Decision to Delivery Interval, Fetal Outcomes and Its Factors Among Emergency Caesarean Section Deliveries at South Gondar Zone Hospitals, Northwest Ethiopia: Retrospective Cross-Sectional Study, 2020

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