Decision to delivery interval for emergency caesarean section in Eastern Uganda: A cross-sectional study

Apako, Teddy; Wani, Solomon; Oguttu, Faith; Nambozo, Brendah; Nahurira, Doreck; Nantale, Ritah; Kamwesigye, Assen; Wandabwa, Julius; Obbo, Stephen; Mugabe, Kenneth; Mukunya, David; Musaba, Milton W.

doi:10.1371/journal.pone.0291953

Cited by 3 publications

(1 citation statement)

References 14 publications

(19 reference statements)

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“…Out of the 582 pregnant women who underwent CS in this study, only 32 (5.5%) had CS within 30 minutes of decision-to-delivery interval with a minimum time of 15.00 minutes. The observation is similar to studies carried out in some tertiary hospitals in Ilorin [6] and Ife [7], both in Nigeria, Kenya [14], and Uganda [15]. The similarities in our ndings compared to the previous studies may be related to the fact that these studies were conducted in low-income countries with similar socioeconomic indices such as low socioeconomic status, levels of education of both the pregnant women and their spouses, maternal occupation, and booking status.…”

Section: Discussionsupporting

confidence: 90%

Impact of 'decision-to-delivery' interval on maternal and perinatal outcomes: A retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Abdulbaki,

Aliyu,

Ayinde

et al. 2024

Preprint

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Background The decision-to-delivery interval (DDI) for a caesarean section is among the factors that reflect the quality of care a pregnant woman receives and the impact on maternal and foetal outcomes and should not exceed 30 minutes. Herein, we aimed to evaluate the effect of decision-to-delivery interval on the maternal and perinatal outcomes among emergency caesarean deliveries at a secondary health facility in north-central Nigeria. Methods We carried out a four-year retrospective descriptive analysis of all emergency caesarean sections at a secondary health facility in north-central Nigeria. We included pregnant mothers who had emergency caesarean delivery at the study site from February 10, 2017, to February 9, 2021. Results Out of 582 who underwent emergency caesarean section, 550 (94.5%) had a delayed decision-to-delivery interval. The factors associated with delayed decision-to-delivery interval included educational levels (both parents), maternal occupation, and booking status. The delayed decision-to-delivery interval was associated increase in perinatal deaths with an odds ratio (OR) of 6.9 (95% CI, 3.166 to 15.040), and increased odds of Special Care Baby Unit (SCBU) admissions (OR 9.8, 95% CI 2.417 to 39.333). Among the maternal outcomes, delayed decision-to-delivery interval was associated with increased odds of sepsis (OR 4.2, 95% CI 1.960 to 8.933), hypotension (OR 3.8, 95% 1.626 TO 9.035), and cardiac arrest (OR 19.5, 95% CI 4.634 to 82.059). Conclusion This study shows a very low optimum DDI, which was associated with educational levels, maternal occupation, and booking status. The delayed DDI increased the odds of perinatal deaths, SCBU admission, and maternal-related complications.

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Section: Discussionsupporting

confidence: 90%

Impact of 'decision-to-delivery' interval on maternal and perinatal outcomes: A retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Abdulbaki,

Aliyu,

Ayinde

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Impact of ‘decision-to-delivery’ interval on maternal and perinatal outcomes: a retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Abdulbaki,

Aliyu,

Ayinde

et al. 2024

BMC Pregnancy Childbirth

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Background The decision-to-delivery interval (DDI) for a caesarean section is among the factors that reflect the quality of care a pregnant woman receives and the impact on maternal and foetal outcomes and should not exceed 30 min especially for Category 1 National Institute for Health and Care Excellence (NICE) guidelines. Herein, we evaluated the effect of decision-to-delivery interval on the maternal and perinatal outcomes among emergency caesarean deliveries at a secondary health facility in north-central Nigeria. Methods We conducted a four-year retrospective descriptive analysis of all emergency caesarean sections at a secondary health facility in north-central Nigeria. We included pregnant mothers who had emergency caesarean delivery at the study site from February 10, 2017, to February 9, 2021. Results Out of 582 who underwent an emergency caesarean section, 550 (94.5%) had a delayed decision-to-delivery interval. The factors associated with delayed decision-to-delivery interval included educational levels (both parents), maternal occupation, and booking status. The delayed decision-to-delivery interval was associated with an increase in perinatal deaths with an odds ratio (OR) of 6.9 (95% CI, 3.166 to 15.040), and increased odds of Special Care Baby Unit (SCBU) admissions (OR 9.8, 95% CI 2.417 to 39.333). Among the maternal outcomes, delayed decision-to-delivery interval was associated with increased odds of sepsis (OR 4.2, 95% CI 1.960 to 8.933), hypotension (OR 3.8, 95% 1.626 TO 9.035), and cardiac arrest (OR 19.5, 95% CI 4.634 to 82.059). Conclusion This study shows a very low optimum DDI, which was associated with educational levels, maternal occupation, and booking status. The delayed DDI increased the odds of perinatal deaths, SCBU admission, and maternal-related complications.

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Comparison of short-term maternal and neonatal outcomes between elective and emergent Cesarean section: A single center experience

Lukić,

Lazić-Mitrović,

Rovčanin

et al. 2024

Medicinska istraživanja

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Introduction/Aim: Increased rates of Cesarean section (CS) and subsequent short-term and long-term maternal complications (MC) and neonatal complications (NC) have been reported. The aim of this study was to compare short-term MC and NC between elective and emergent CS. Material and Methods: Data from medical records of pregnant women who had undergone CS at Gynecology and Obstetrics Clinic "Narodni front" were retrospectively collected. The inclusion criteria were as follows: low-risk, term monofetal pregnancies with obstetrical CS-indications and other non-life-threatening maternal conditions (ophthalmological, orthopedic, psychiatric, lower genital-tract infections). Short-term MC were the following: surgical complications, inflammatory syndrome, the need for blood transfusion, and hospital stay ≥5 days. NC were as follows: respiratory morbidity, asphyxia, sepsis, injuries/lacerations, admission to neonatal intensive-care-unit, hospital stay >4 days. Results: We included 1056 singleton pregnancies. Mean age was 32.63±5.38 years, mainly primipara 566 (53.6%). Of all CS, 774 (73%) were performed emergently. Cephalopelvic disproportion/fetal macrosomia and other CS indications carried a significantly high risk for emergent CS (OR=3.943, 95%CI 2.036-6.591; OR=7.560, 95%CI 3.994-8.327, respectively). Regardless of the urgency of CS there were no significant differences in the frequency of MC. Neonatal sepsis was significantly higher after emergent CS (p=0.027), with a two-times greater risk for its development (OR=2.070, 95% CI 1.072-3.997). There were no fatal maternal/neonatal outcomes and no need for additional care. Conclusion: There were no notable disparities in MC and NC among the individuals who had undergone emergent and elective CS. Neonates born by means of emergent CS had a higher risk of developing neonatal sepsis. Indications for CS had a greater impact on short-term maternal and fetal outcomes than the type of CS.

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Decision to delivery interval for emergency caesarean section in Eastern Uganda: A cross-sectional study

Cited by 3 publications

References 14 publications

Impact of 'decision-to-delivery' interval on maternal and perinatal outcomes: A retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Impact of 'decision-to-delivery' interval on maternal and perinatal outcomes: A retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Impact of ‘decision-to-delivery’ interval on maternal and perinatal outcomes: a retrospective study of emergency caesarean section from 2017 to 2021 at a secondary health facility in Nigeria

Comparison of short-term maternal and neonatal outcomes between elective and emergent Cesarean section: A single center experience

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