Decision to delivery interval and associated factors for emergency cesarean section: a cross-sectional study

Abstract

Background Emergency cesarean section is a commonly performed surgical procedure in pregnant women with life-threatening conditions of the mother and/or fetus. According to the Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists, decision to delivery interval for emergency cesarean sections should be within 30 min. It is an indicator of quality of care in maternity service, and if prolonged, it constitutes a third-degree delay. This study aimed to assess the decision to delivery interval and associated factors for emergency cesarean section in Bahir Dar City Public Hospitals, Ethiopia. Method An institution-based cross-sectional study was conducted at Bahir Dar City Public Hospitals from February to May 2020. Study participants were selected using a systematic random sampling technique. A combination of observations and interviews was used to collect the data. Data entry and analysis were performed using Epi-data version 3.1 and SPSS version 25, respectively. Statistical significance was set at p < 0.05. Result Decision-to-delivery interval below 30 min was observed in 20.3% [95% CI = 15.90–24.70%] of emergency cesarean section. The results showed that referral status [AOR = 2.5, 95% CI = 1.26–5.00], time of day of emergency cesarean section [AOR = 2.5, 95%CI = 1.26–4.92], status of surgeons [AOR = 2.95, 95%CI = 1.30–6.70], type of anesthesia [AOR = 4, 95% CI = 1.60–10.00] and transfer time [AOR = 5.26, 95% CI = 2.65–10.46] were factors significantly associated with the decision to delivery interval. Conclusion Decision-to-delivery intervals were not achieved within the recommended time interval. Therefore, to address institutional delays in emergency cesarean section, providers and facilities should be better prepared in advance and ready for rapid emergency action.

Perinatal Asphyxia and Its Associated Factors among Live Births in the Public Health Facilities of Bahir Dar City, Northwest Ethiopia, 2021

“…This might be since relatively fewer health care providers are hired to follow laboring mothers and also to attend the delivery with a high burden at night time. The higher likelihood of perinatal asphyxia during the night time may also be due to relatively longer decisions to the delivery interval at night than in daytime during emergency C/S [ 51 ]. Furthermore, it may also be due to consultation hierarchy and sometimes consulted senior delayed arrival for difficult labor at night time, which may have played its role.…”

Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination

“…New patients, who were the first time to visit our clinic, were excluded. Eligible patients were invited to participate using a systematic random sampling technique 9. The sampling fraction was determined by dividing the total 8-month follow-up numbers by the sample size.…”

“…Eligible patients were invited to participate using a systematic random sampling technique. 9 The sampling fraction was determined by dividing the total 8-month follow-up numbers by the sample size. The first participant was selected as his or her first visiting sequence on our research initiating date and every second interval was included using systematic random sampling.…”

The evaluation of decision-to-delivery interval in category-1 emergency cesarean section: a report of six cases

“…In our subjects, four patients received the surgery at daytime and two received at nighttime. It is noted that category-1 emergency C/S performed in the daytime had a statistically shorter DDI when compared with the nighttime (odds ratio=2.49, 95% confidence interval=1.26–4.92) [ 4 ]. Fortunately, the two patients received nighttime surgery were transferred to our institution soon after the other emergency surgery completed, and human resources were thus available easily.…”

“…Fifth, general anesthesia was selected. Patients who received general anesthesia were 4 times more likely to achieve the 30-min goal than those who received regional anesthesia (odds ratio=4.0, 95% confidence interval=1.6–10.0) [ 4 ]. On the other hand, the use of general anesthesia for category-1 emergency C/S was 74.3% after the COVID-19 pandemic, which was significantly lower than that before the COVID-19 pandemic, at 86.6% ( p value=0.037) [ 5 ].…”