Emergency Caesarean Section : Influences on the Decision-to-Delivery Interval

Abstract EN

RCOG/NICE guidelines recommend that, for fetal compromise in labour, delivery should be accomplished ideally within 30 minutes.

In this study, we investigated the factors which affect the decision-to-delivery (DD) intervals for emergency caesareans.

To achieve this, prospective data were collected for all grade 1 and 2 caesareans performed on a busy labour ward over 12 months.

We found that the ratio of labouring women to midwives had a significant effect on the DD intervals, which were significantly prolonged when 1 : 1 care was not provided (P<0.001).

The observed effect resulted exclusively from a prolonged transfer time to theatre.

General anesthesia use shortened the DD interval for grade 1 caesareans (P<0.001) and was more likely to be used during the day shift (P<0.009).

We conclude that midwifery staffing levels and the form of anaesthesia employed influence on DD intervals for the most urgent caesarean sections.