Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases Repeated cross-sectional study from Oman
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 1
Abstract
Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. Tis study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. Methods: Tis repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Tree audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defned as Apgar scores of <7 at fve minutes, admission to the Special Care Baby Unit (SCBU) or a stillbirth. Results: In the initial cycle, a DDI of ≤30 minutes was achieved in 23.8% of 84 cases in comparison to 44.6% of 83 cases in the second cycle. In the third cycle, 60.8% of 79 women had a DDI of ≤30 minutes (P <0.001). No signifcant differences in perinatal outcomes for cases with a DDI of ≤30 minutes versus 31–60 minutes were observed; however, a DDI of >60 minutes was signifcantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each). Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre. Conclusion: Te identifcation of factors causing DDI delays may provide opportunities to improve perinatal outcomes.
Authors and Affiliations
Kaukab Tashfeen| Departments of Obstetrics & Gynaecology , Nizwa Hospital, Nizwa, Oman, Malini Patel| Departments of Obstetrics & Gynaecology , Nizwa Hospital, Nizwa, Oman, Ilham M. Hamdi| Departments of Obstetrics & Gynaecology , Nizwa Hospital, Nizwa, Oman, Ibrahim H. A. Al-Busaidi| Departments of Statistics, Nizwa Hospital, Nizwa, Oman, Mansour N. Al-Yarubi| Departments of Statistics, Nizwa Hospital, Nizwa, Oman
Keywords
Related Articles
- EP ID EP14744
- DOI 10.18295/squmj.2016.17.01.008
- Views 342
- Downloads 17
Focal Scalp Hair Heterochromia in an Infant
Hair heterochromia involves the presence of two different non-artifcially induced colours of hair in the same individual which can be due to either iron defciency anaemia, genetic mutations or mosaicism. We report a s...
The Smallest Miracle Baby that Survived in Oman
Extreme prematurity is a major cause of perinatal morbidity and mortality. Management of such babies is a big challenge to neonatologists. Here we report the smallest baby ever survived in Oman.
Primary Combined Latissimus Dorsi and Serratus Anterior Flap Repair of Right-Sided Congenital Diaphragmatic Agenesis in a Neonate
Large diaphragmatic defects can be repaired with latissimus dorsi and serratus anterior muscle flaps. We report the frst successful primary repair of complete congenital diaphragmatic agenesis using a combination of a...
Minor Oral Surgery Procedures in Patients Taking Warfarin A 5-year retrospective study at Sultan Qaboos University Hospital, Sultanate of Oman
Minor oral surgery (MOS) procedures in warfarinised patients carry the risk of post-operative bleeding. Te aim of this study was to conduct a retrospective analysis and to describe the profle of warfarinised patients w...
Risk Factors Associated with Denture Stomatitis in Healthy Subjects Attending a Dental School in Southeast Iran
Objectives: Tere is scant information regarding the multifactorial aetiology of denture stomatitis (DS) in the world and, despite its frequency, associated factors are not completely understood. Te aim of this study wa...