Crash caesarean section – decision‐to‐delivery interval

Kwek, Kenneth; Yeap, Min Li; Tan, Kok Hian; Tee, John C. S.; Yeo, G. S. H.

doi:10.1111/j.0001-6349.2005.00816.x

Cited by 11 publications

(13 citation statements)

References 5 publications

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“…Kwek et al reported an overall mean DDI of 14.6 (range 3-32) minutes. (6) Nair et al reported a mean DDI of crash CSs of 10.8 (range 3-31) minutes. This was made possible by ensuring that there is always an operating theatre on standby throughout the day for crash CSs and by activating a 'code green' via a public address system, to activate the team required instead of notifying individual doctors.…”

Section: Discussionmentioning

confidence: 99%

Decision-to-delivery intervals and total duration of surgery for Caesarean sections in a tertiary general hospital

Wong

Lau

Tan

et al. 2017

smedj

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Section: Discussionmentioning

confidence: 99%

Decision-to-delivery intervals and total duration of surgery for Caesarean sections in a tertiary general hospital

Wong

Lau

Tan

et al. 2017

smedj

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“…Sayegh et al [7] implemented a colour code to indicate the urgency level and ensure that all those concerned associated this with a time to delivery that should not be exceeded. Others proposed very similar ways of communicating the degree of urgency: the 'crash emergency cesarean section' of Hillemanns et al [18] , MacKenzie and Cooke [16] and Kwek et al [19] and the classification in three levels of urgency (1, 2 and 3) of Roemer and Heger-Romermann [20] . Such means help communication and appear to be indispensable for improving cooperation between the various members of the healthcare team.…”

Section: Discussionmentioning

confidence: 99%

Identification of Factors Influencing the Decision-to-Delivery Interval in Emergency Caesarean Sections

Chauleur

Collet²,

Furtos³

et al. 2009

Gynecol Obstet Invest

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Background: In a life-threatening context, the American College of Obstetrics and Gynecology and the Royal College of Obstetrics and Gynaecology recommend a maximum delay of 30 min between the decision to perform an emergency caesarean and the infant’s birth. Our objectives were to estimate the rate of prolonged intervals and identify the factors influencing the decision-to-delivery interval. Methods: All women who had given birth at Saint-Etienne University Hospital by a non-prophylactic caesarean section between September 1 and November 1, 2007 were included in a prospective cohort study. A linear regression analysis was performed to identify the factors influencing the decision-to-delivery interval. Results: 68 women were included in the study. Regardless of the degree of emergency, the decision-to-delivery interval exceeded the recommended interval in 50% of the cases. In extremely urgent caesarean sections, the optimal interval of 15 min was exceeded in 85.7% of cases. We found that two factors contributed to delayed patient care: urgent and extremely urgent caesareans and hospitalization in a pathological pregnancy unit. This delay leads to more paediatric reanimations. Conclusion: This study highlights the difficulty to reach the recommended target interval. One solution is to improve the identification of the degree of urgency and the communication between the various members of the healthcare team.

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“…Ce taux est élevé en comparaison des données publiées par d'autres équipes. Quatre études publiées entre 2002 et 2006 rapportent des taux de césariennes en extrême urgence variant de 0,4 à 0,7 % de l'ensemble des accouchements et de 2,5 à 3,4 % des césariennes [11][12][13][14]. Deux études successives réalisées en 2003 et 2007 dans une maternité de type 3 a montré un taux de césariennes « code rouge » variant de 1 à 0,8 % de l'ensemble des accouchements et de 5,5 à 3,4 % des césariennes totales, après la réalisation d'audits successives associées à la mise en place d'une procédure systématisée qui visait à réduire le délai entre la décision d'extraction et la naissance [2,3].…”

Section: Discussionunclassified

“…En revanche, l'impact du degré d'urgence de la césarienne sur la morbidité maternelle est mal connu car il reste difficile de différencier la morbidité liée à la procédure de celle liée à l'indication de la césarienne. L'étude de Kwek et al rapporte une morbidité maternelle de 17,5 % dans une cohorte de 114 césariennes en extrêmes urgences, essentiellement représentées par des déchirures du segment inférieur et des hyperthermies postopératoires [11]. En revanche, l'étude cas-témoins de Hillemans et al, qui compare la morbidité maternelle entre les césariennes en extrême urgences et les césarienne en cours de travail, ne retrouve pas de différence significative [17].…”

Section: Discussionunclassified