Emergency caesarean section: An analysis of maternal and fetal outcome

Yeap, Min Li; Tan, Kok Hian; Tee, Chee Seng John; Yeo, S.

doi:10.1016/s0020-7292(00)82006-8

Cited by 2 publications

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“…A prospective audit carried out in 1999 found a mean DDI of 14.9 min. [ 8 ] Using public announcement system and dedicated category-one CS operating theatre (OT), the mean DDI was 7.7 min in a subsequent 1-year prospective audit conducted in 2004. [ 9 ] We conducted this retrospective cohort study to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

Dunn

Zhang

Sia³

et al. 2016

Indian J Anaesth

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Background and Aims:A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (‘crash’) CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS.Methods:This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05.Results:The mean (standard deviation) DDI was 9.4 (3.2) min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9%) of women had general anaesthesia (GA) for category-one CS. Of those who had an epidural catheter already in situ (34.4%), 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA).Conclusions:Our ‘crash’ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9%) of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA.

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Section: Introductionmentioning

confidence: 99%

Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

Dunn

Zhang

Sia³

et al. 2016

Indian J Anaesth

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Evaluation of Surgical and Anaesthesia Response Times for Crash Caesarean Sections – An Audit of a Singapore Hospital

Lim,

Shah,

Tan

2005

Ann Acad Med Singap

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Introduction: The Royal College of Obstetricians and Gynaecologists published the “Organisational Standards for Maternity Services” in 1995, in which they proposed that there be a maximum decision-to-delivery time of 30 minutes for urgent caesarean sections (CS). In 1997, our institution established a protocol for extremely urgent (“crash”) CS to expedite delivery time and to conform to this standard. Materials and Methods: The objective of this prospective audit was to determine the surgical and anaesthesia response times in our institution after the protocol had been implemented. The audit was conducted in KK Women’s and Children’s Hospital from February 2003 to January 2004, over a 12-month period. Upon activation of a “crash” CS, the attending anaesthetist was required to record the decision-to-anaesthesia time, decision-to-delivery time and the perinatal outcome. Results: Ninety-eight cases of “crash” CS were identified from a total of 3629 elective and non-elective CS, with 80 cases having complete data. The mean decision-to-delivery interval was 7.7 min ± 3.0 (SD) with 100% of deliveries made within 17 minutes. The mean decision-to-anaesthesia time was 3.5 min ± 2.0 (SD) with all the patients anaesthetised within 10 minutes. The majority (88.8%) of the patients had general anaesthesia for “crash” CS while the rest had successful epidural block extension. There was no significant difference in the decision-to-delivery interval or mean cord blood pH with respect to the type of anaesthesia given. Conclusions: We achieved 100% deliveries within the proposed 30-minute decision-to-delivery time interval by implementing a protocol for “crash” CS. Both general anaesthesia and extension of existing epidural block are acceptable modes of anaesthesia and do not delay delivery of the fetus.

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Emergency caesarean section: An analysis of maternal and fetal outcome

Cited by 2 publications

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Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

Evaluation of Surgical and Anaesthesia Response Times for Crash Caesarean Sections – An Audit of a Singapore Hospital

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