Factors influencing cesarean delivery operative times: a prospective observational cohort study

Wilson, Sylvia H.; Fecho, Karamarie; Marshall, Julie; Spielman, Fred J.

doi:10.1016/j.ijoa.2010.06.009

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…5 Three studies looking specifically at CD operative times showed that surgeon experience does influence operative times, though with conflicting results between studies. 6,7,10 Our results are in agreement with those described by Doherty et al 7 and Wong et al 10 with training surgeons increasing CD operative times by 5–14 minutes depending on their level of training. In contrast, Wilson et al 6 showed decreased operative time when CD was performed by residents or fellows compared to attendings.…”

Section: Discussionsupporting

confidence: 92%

“…6,7,10 Our results are in agreement with those described by Doherty et al 7 and Wong et al 10 with training surgeons increasing CD operative times by 5–14 minutes depending on their level of training. In contrast, Wilson et al 6 showed decreased operative time when CD was performed by residents or fellows compared to attendings. This difference could be related to institutional protocols, some of which may call for a second attending to assist with challenging cases that are deemed inappropriate for training physicians, while the less complicated cases are performed by residents and fellows.…”

Section: Discussionsupporting

confidence: 92%

“…Neuraxial anesthesia is the preferred mode of anesthesia for the vast majority of CDs in the developed world, due to safety concerns, and maternal and obstetric care provider preferences. 6 Anesthesiologists use the anticipated duration of a CD to guide the choice of specific neuraxial technique for CD. Accurate information about CD operative times can aid in selecting the optimal anesthetic plan.…”

Section: Discussionmentioning

confidence: 99%

“…Factors affecting CD times, such as the surgeon’s experience, the patient’s BMI and race/ethnicity, the fetal gestational age, a history of a previous CD, concurrent bilateral tubal ligation, previous abdominal surgery other than CD, the CD indication and urgency, and the type of uterine incision (vertical versus low transverse), have been described 4,6,7 but differences in practices exist that make such results only moderately generalizable. In this single-center study, our primary aim was to determine institutional operative times for first, second, third and fourth or more CDs at our institution, which is a tertiary/quaternary care urban academic medical center.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Fiol

Meng

Danhakl

et al. 2018

International Journal of Obstetric Anesthesia

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Background: Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determine operative times and the factors influencing those times for cesarean delivery. Methods: We conducted a retrospective review of all 1348 cesarean deliveries performed at an academic hospital in 2011. The primary outcome was mean operative time for first, second, third and fourth or more cesarean deliveries. The secondary goal was to identify factors influencing operative time. Variables included age, body mass index, previous surgery, gestational age, urgency of cesarean delivery, anesthesia type, surgeon’s seniority, layers closed, and performance of tubal ligation. Results: Mean (standard deviation) operative times for first (n=857), second (n=353), third (n=108) and fourth or more (n=30) cesarean deliveries were 56 (19), 60 (19), 69 (28) and 82 (31) minutes, respectively (P <0.0001, all groups different). Emergency status of the case and later gestational age were associated with shorter operative times. Higher body mass index, a less senior surgeon, the number of layers closed, and tubal ligation, increased operative times. These factors accounted for 18% of the variability. Conclusions: Third and fourth cesarean delivery or the presence of other factors that could increase operative time may warrant catheter-based anesthetic techniques or the addition of adjunctive medications to prolong spinal anesthetic block. Institutional and individual surgeon factors may play an even more important role in determining surgical time.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Fiol

Meng

Danhakl

et al. 2018

International Journal of Obstetric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Under some circumstances, however, including inadequate block 13, 14 and prolonged operating time 15 , planned regional anesthetic requires conversion to general anesthetic. In this scenario, the mother and baby are exposed to the risks of both types of anesthesia within the same procedure.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section

Aiken

Cole

et al. 2015

J Perinatol

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Objective To investigate risk factors predicting unplanned conversion to general anesthesia during elective cesarean section and to examine maternal and fetal outcomes associated with unplanned conversion compared to other modes of anesthesia. Study Design A retrospective cohort at a UK center (2008-2013). 4337 women underwent elective cesarean section. Delivery outcomes were compared according to anesthesia type using logistic regression. Results 1.6% of women underwent unplanned conversion to general anesthetic. Unplanned conversion was associated with higher parity (OR 3.82, CI (1.58-9.62)) and maternal age ≥40 (OR 4.40, CI(1.08-29.88)). Compared to spinal anesthetic, unplanned conversion was associated with increased likelihood of maternal hemorrhage ≥1.5 litres (OR 5.74, CI (1.90-14.01)) and delayed neonatal respiration (OR 4.76, CI (1.76-11.05)). Adverse outcomes were not significantly more likely compared to planned general anesthetic. Conclusions Higher parity and maternal age are risk factors for unplanned conversion to general anesthetic. There is no increase in the likelihood of adverse outcomes with unplanned versus planned general anesthetic.

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Prolonged operative time of cesarean is a risk marker for subsequent cesarean maternal complications

Nun

Sela

Joseph

et al. 2022

Arch Gynecol Obstet

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Factors influencing cesarean delivery operative times: a prospective observational cohort study

Cited by 8 publications

References 13 publications

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

A study of factors influencing surgical cesarean delivery times in an academic tertiary center

Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section

Prolonged operative time of cesarean is a risk marker for subsequent cesarean maternal complications

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