The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes

Grobman, William A.; Bailit, Jennifer L.; Sandoval, Grecio; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T.N.; Saade, George R.; Sorokin, Yoram; Rouse, Dwight J.; Tolosa, Jorge E.

doi:10.1055/s-0037-1606641

Cited by 18 publications

(8 citation statements)

References 11 publications

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“…Even though we anticipated that a prolonged DDI would lead to an increased incidence of adverse neonatal outcome, we were unable to show any significant impact. Results were compliant with most published studies covering the topic (9,11,12,21,23,25,26). For instance similar results were reported by Grobman et al (23).…”

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 91%

“…Thereby resulting in shortened DDI being associated with worsened neonatal outcome. Comparable results were already described in prior studies (16,23,24).…”

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 89%

“…Results were compliant with most published studies covering the topic (9,11,12,21,23,25,26). For instance similar results were reported by Grobman et al (23). They stated that even a decision to incision time ≥30 min in patients undergoing ECS for fetal indications was not associated with worsened neonatal outcome whereby it also needs to be considered that the most emergent indications for ECS, abruption and cord prolapse were excluded in the study.…”

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 84%

“…Our data did not qualify to make a statement concerning maternal complications but Moroz et al (31), for instance, reported that among women who underwent emergent repeat Cesarean section the risk of maternal complications was increased if the incision to delivery interval was ≤2 min. Other studies, however, showed no impact of duration of DDI on maternal outcome (9,23).…”

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomementioning

confidence: 94%

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Evaluating the Decision-to-Delivery Interval in Emergency Cesarean Sections and its Impact on Neonatal Outcome

Brandt

Morgenstern

Thangarajah

et al. 2020

In Vivo

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Background/Aim: In Germany, performance of an emergency Cesarean section (ECS) is recommended within an interval of ≤20 min from decision to delivery (DDI). The aim of the study was to assess the duration of DDI in ECS as well as its impact on neonatal outcome. Patients and Methods: Data from 437 patients at a single, tertiary care hospital were retrospectively analysed regarding influence on the duration of DDI. Subsequently the impact of DDI on neonatal outcome and incidence of adverse neonatal outcome was analysed. Results: DDI of ECS performed outside core working hours was significantly prolonged (p<0.001). Shorter DDI showed a statistically worse arterial cord blood pH (p=0.001, r=0.162) and base excess (p=0.05; r=0.094). Duration of DDI had no significant impact on the incidence of adverse neonatal outcome (p=0.123). Conclusion: Awareness of influence on DDI might contribute to expediting DDI, but duration of DDI showed no impact on the incidence of adverse neonatal outcome. Data were not adequate to suggest a recommendation for DDI time standards.Cesarean section is the most commonly performed major surgery in obstetrics. In an emergency its immediate performance seems to be necessary in order to minimize the risk of permanent fetal damages and to prevent fatal complications. Emergency Cesarean section (ECS) is required in approximately 1% of pregnancies (1).In Germany the time interval from indicating an ECS until the actual delivery of the neonate, also known as decision to delivery interval (DDI), is recommended to be ≤20 min (2).

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Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 91%

“…Thereby resulting in shortened DDI being associated with worsened neonatal outcome. Comparable results were already described in prior studies (16,23,24).…”

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 89%

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomesupporting

confidence: 84%

Section: Impact Of Decision To Delivery Interval On Neonatal Outcomementioning

confidence: 94%

See 2 more Smart Citations

Evaluating the Decision-to-Delivery Interval in Emergency Cesarean Sections and its Impact on Neonatal Outcome

Brandt

Morgenstern

Thangarajah

et al. 2020

In Vivo

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“…Further search through the references of these 90 papers revealed another 9 papers, resulting in 99 being included in the final analysis . Of these 99 papers, 86 used the decision-todelivery interval as a primary or secondary performance measure [3, 4, 7-11, 14-20, 22-25, 27-29, 31-43, 45-47, 49-60, 62-73, 75-79, 81-95, 97-101] and 13 used decision-to-incision interval [5,6,12,13,21,26,30,44,48,61,74,80,96]. Of those where decision-to-delivery interval was the outcome measure, 56 out of 86 (65%) did not specify a definition for the decision.…”

Section: Resultsmentioning

confidence: 99%

Defining the decision‐to‐delivery interval at caesarean section: narrative literature review and proposal for standardisation

May

Richardson

et al. 2021

Anaesthesia

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The decision-to-delivery interval is a widely used term at non-elective caesarean section. While the definition may appear self-evident, there is no universally agreed consensus about when this period begins and ends. We reviewed the literature for original research utilising the terms 'decision-to-delivery', 'decision-to-incision' or 'incision-to-delivery' and examined definitions used for decision, delivery, incision, as well as any additional time intervals that were assessed. Our analysis demonstrated an inconsistent non-standardised approach to defining these intervals, which might have clinical practice and medicolegal ramifications. We propose that the decision-to-delivery interval should be defined as follows: the interval between the time at which the senior obstetrician makes the decision that a caesarean section is required and the time at which the fetus (or first fetus in the case of multiples) is delivered. The decision time should ideally be recorded contemporaneously in the medical notes or partogram.

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Geburtsüberwachung

Gnirs,

Schneider,

Kühnert

et al. 2022

Die Geburtshilfe

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The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes

Abstract: In this analysis, DTI times longer than 30 minutes were not associated with worse maternal or neonatal outcomes.

Cited by 18 publications

References 11 publications

Evaluating the Decision-to-Delivery Interval in Emergency Cesarean Sections and its Impact on Neonatal Outcome

Evaluating the Decision-to-Delivery Interval in Emergency Cesarean Sections and its Impact on Neonatal Outcome

Defining the decision‐to‐delivery interval at caesarean section: narrative literature review and proposal for standardisation

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