Publication:

Factors affecting “decision to delivery interval” in emergency caesarean sections in a tertiary care hospital: a cross sectional observational study

Background The objective was to assess the waiting time and factors affecting the decision to delivery interval in an emergency caesarean section and to correlate it with neonatal and maternal outcomes.

Methods This study was conducted in the Department of Obstetrics & Gynaecology at UCMS and GTB Hospital, Delhi which is a government supported tertiary care hospital located in East Delhi. Data of 275 emergency caesarean sections was collected and analyzed for decision to delivery interval (DDI) along with the causes of delay and maternal and fetal outcomes.

Results The mean DDI was 183.24 minutes for all 275 cases and was 122 ± 89min for category I caesarean sections (crash caesareans). The major cause of delay was non availability of operation theatres due to long list of waiting caesareans sections. When the mean DDI exceeded 75 minutes, there was a 4.6 fold increase in the risk to the life of neonate while the maternal outcome was not significantly affected.

Conclusion DDI of 30 minutes is difficult to achieve even for urgent caesarean sections in government based set up of a developing nation, therefore a more reasonable time frame of 60-75 min may be justified for emergency caesarean sections under similar set up.