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
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- EP ID EP14744
- DOI 10.18295/squmj.2016.17.01.008
- Views 335
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