Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes

Doherty, Dorota; Magann, Everett F.; Chauhan, Suneet P.; O’Boyle, Amy L.; Busch, Jeanne M.; Morrison, John C.

doi:10.1111/j.1479-828x.2008.00862.x

Cited by 35 publications

(33 citation statements)

References 10 publications

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“…5 Three studies looking specifically at CD operative times showed that surgeon experience does influence operative times, though with conflicting results between studies. 6,7,10 Our results are in agreement with those described by Doherty et al 7 and Wong et al 10 with training surgeons increasing CD operative times by 5–14 minutes depending on their level of training. In contrast, Wilson et al 6 showed decreased operative time when CD was performed by residents or fellows compared to attendings.…”

Section: Discussionsupporting

confidence: 92%

“…Factors affecting CD times, such as the surgeon’s experience, the patient’s BMI and race/ethnicity, the fetal gestational age, a history of a previous CD, concurrent bilateral tubal ligation, previous abdominal surgery other than CD, the CD indication and urgency, and the type of uterine incision (vertical versus low transverse), have been described 4,6,7 but differences in practices exist that make such results only moderately generalizable. In this single-center study, our primary aim was to determine institutional operative times for first, second, third and fourth or more CDs at our institution, which is a tertiary/quaternary care urban academic medical center.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Fiol

Meng

Danhakl

et al. 2018

International Journal of Obstetric Anesthesia

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Background: Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determine operative times and the factors influencing those times for cesarean delivery. Methods: We conducted a retrospective review of all 1348 cesarean deliveries performed at an academic hospital in 2011. The primary outcome was mean operative time for first, second, third and fourth or more cesarean deliveries. The secondary goal was to identify factors influencing operative time. Variables included age, body mass index, previous surgery, gestational age, urgency of cesarean delivery, anesthesia type, surgeon’s seniority, layers closed, and performance of tubal ligation. Results: Mean (standard deviation) operative times for first (n=857), second (n=353), third (n=108) and fourth or more (n=30) cesarean deliveries were 56 (19), 60 (19), 69 (28) and 82 (31) minutes, respectively (P <0.0001, all groups different). Emergency status of the case and later gestational age were associated with shorter operative times. Higher body mass index, a less senior surgeon, the number of layers closed, and tubal ligation, increased operative times. These factors accounted for 18% of the variability. Conclusions: Third and fourth cesarean delivery or the presence of other factors that could increase operative time may warrant catheter-based anesthetic techniques or the addition of adjunctive medications to prolong spinal anesthetic block. Institutional and individual surgeon factors may play an even more important role in determining surgical time.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Fiol

Meng

Danhakl

et al. 2018

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Prolonged operative times have been associated with increased blood loss, infectious morbidity, and surgical complications. [7][8][9] Our study does not demonstrate causation but highlights an association of longer cesarean operative times in the first 8 years after implementation of the 80-hour workweek. Interpreting the causes and implications of these trends is challenging, given the multitude of factors that may potentially impact surgical time.…”

Section: Discussionmentioning

confidence: 99%

Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek

Smrtka

Gunatilake

Harris

et al. 2015

Journal of Graduate Medical Education

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“…As caesarean section is a commonly used procedure and the clinical characteristics of subjects in the two groups were not significantly different, there was no significant difference in opertaton time between the two groups. In a retrospective study, Doherty et al [25] reported the operation time of caesarean section was significantly related to the characteristics of the patients, including age, BMI, prior caesarean section and experience and skill of operators. Moreover, they also found that operation time was related to uterine incision.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of “J”-shaped uterine incision during caesarean section in patients with placenta previa: A retrospective study

Zou

Zhong

Yin

et al. 2010

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa. A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months. The subjects were divided into two groups with respect to the uterine incision. Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine incision and 31 pregnant women with placenta previa received caesarean section that used the traditional transverse incision. The two groups were compared in terms of operation time, estimated blood loss, infant expulsion time, exhaust time and postoperative recovery. Meanwhile, comparison was also made in neonatal clinical data between the two groups. Compared with the "J"-shaped incision group, the traditional incision group had a lower Apgar scores (P<0.05). However, there existed no statistically significant differences in the overall time of operation and postoperative period of breaking wind (P>0.05). It is concluded that, with caesarean section for placenta previa patients, the "J"-shaped uterine incision significantly decreases intraoperative blood loss and facilitates the fetal delivery.

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Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes

Cited by 35 publications

References 10 publications

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek

Evaluation of “J”-shaped uterine incision during caesarean section in patients with placenta previa: A retrospective study

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