Evaluation of decision-to-delivery interval in emergency cesarean section: A 1-year prospective audit in a tertiary care hospital

Gupta, Sunanda; Naithani, Udita; Madhanmohan, C; Singh, Ajay; Reddy, P Srinivasa; Gupta, Apoorva

doi:10.4103/0970-9185.202197

Cited by 33 publications

(48 citation statements)

References 22 publications

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“…The current study showed that only 19.6% of women who underwent category-1 emergency C/S were delivered within the recommended DDI of 30 min. The mean ± SD of DDI was 42 ± 21.4 min which is similar with a study done by Sunanda et al in which the mean ± SD was 36.3 ± 17 min [21]. The difference might be due to sample size.…”

Section: Discussionsupporting

confidence: 88%

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: 88%

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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“…A developing country-based evidence showed that financial constraints have been cited as a reason to refusal to CS delivery [37]. We found better CS service uptake among educated women than non-educated women as confirmed in prior studies (34, 37. In Africa, by prospecting vaginal delivery will occur, poor birth outcome finally happened even with CS performed [39], because of delay in getting CS delivery timely [40]. The possible mechanism through which higher level of education increases the odd of CS delivery could be that, more educated women are likely to develop decision making power, which in turn, may rise the chance that women could get CS service [41].…”

Section: Discussionmentioning

confidence: 99%

Magnitude and trends in socio-economic and geographic inequality in access to birth by cesarean section in Tanzania: evidence from five rounds of Tanzania demographic and health surveys (1996–2015)

Shibre

Zegeye²,

Keetile

et al. 2020

Arch Public Health

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Background Majority of maternal deaths are avoidable through quality obstetric care such as Cesarean Section (CS). However, in low-and middle-income countries, many women are still dying due to lack of obstetric services. Tanzania is one of the African countries where maternal mortality is high. However, there is paucity of evidence related to the magnitude and trends of disparities in CS utilization in the country. This study examined both the magnitude and trends in socio-economic and geographic inequalities in access to birth by CS. Methods Data were extracted from the Tanzania Demographic and Health Surveys (TDHSs) (1996–2015) and analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. First, access to birth by CS was disaggregated by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference (D), Ratio (R), Slope Index of Inequality (SII) and Relative Index of Inequality (RII). A 95% confidence interval was constructed for point estimates to measure statistical significance. Results The results showed variations in access to birth by CS across socioeconomic, urban-rural and regional subgroups in Tanzania from 1996 to 2015. Among the poorest subgroups, there was a 1.38 percentage points increase in CS coverage between 1996 and 2015 whereas approximately 11 percentage points increase was found among the richest subgroups within same period of time. The coverage of CS increased by nearly 1 percentage point, 3 percentage points and 9 percentage points among non-educated, those who had primary education and secondary or higher education, respectively over the last 19 years. The increase in coverage among rural residents was 2 percentage points and nearly 8 percentage points among urban residents over the last 19 years. Substantial disparity in CS coverage was recorded in all the studied surveys. For instance, in the most recent survey, pro-rich (RII = 15.55, 95% UI; 10.44, 20.66, SII = 15.8, 95% UI; 13.70, 17.91), pro-educated (RII = 13.71, 95% UI; 9.04, 18.38, SII = 16.04, 95% UI; 13.58, 18.49), pro-urban (R = 3.18, 95% UI; 2.36, 3.99), and subnational (D = 16.25, 95% UI; 10.02, 22.48) absolute and relative inequalities were observed. Conclusion The findings showed that over the last 19 years, women who were uneducated, poorest/poor, living in rural settings and from regions such as Zanzibar South, appeared to utilize CS services less in Tanzania. Therefore, such subpopulations need to be the central focus of policies and programmes implemmentation to improve CS services coverage and enhance equity-based CS services utilization.

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“…[8][9][10][11][12][13]16 This proportion is much lower than that found in developing countries of between 55 to 65 percent. 2,7 Some authors have shown that emergency caesarean sections were associated with higher risks for maternal and infant morbidity while others give contrary results.…”

Section: Discussionmentioning

confidence: 99%

Decision to incision interval for emergency caesarean section and postoperative outcomes in a resource limited rural Kenyan public hospital

Kamotho¹,

Pertet²,

Ogwayo³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Standard guidelines recommend that delivery by caesarean section should be ideally initiated within 30 minutes of the decision to operate to avoid maternal and foetal compromise in labour. The purpose of this study was to investigate the extent to which these guidelines can be achieved in limited resource hospital.Methods: Authors used a secondary data from 330 patient's files of women who had a caesarean section from December 2013 retrospectively to January 2012.Results: The main indications for caesarean section was obstructed labour (18.5%) for mothers and foetal distress (6.4%). Though 74% of the mothers gave consent to be operated within the 30-minute guideline, only 3% were prepared for operation within this period. Only 24% of the caesarean sections were conducted within one hour after the decision was made for the operation. About 38% of the women, and 30% of the babies developed complications after the caesarean section. Haemorrhage was the leading complication in mothers while the main complication for babies was babies with an Apgar score of 5 and below.Conclusions: The 30- minute recommended guideline for caesarean section was not achieved, and there was evidence of adverse post-operative outcome as a result of not meeting the global standards.

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Evaluation of decision-to-delivery interval in emergency cesarean section: A 1-year prospective audit in a tertiary care hospital

Cited by 33 publications

References 22 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

Magnitude and trends in socio-economic and geographic inequality in access to birth by cesarean section in Tanzania: evidence from five rounds of Tanzania demographic and health surveys (1996–2015)

Decision to incision interval for emergency caesarean section and postoperative outcomes in a resource limited rural Kenyan public hospital

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