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Decision‐to‐delivery intervals and perinatal outcomes following emergency cesarean delivery in a Nigerian tertiary hospital
Author(s) -
Bello Folasade A.,
Tsele Taiwo A.,
Oluwasola Timothy O.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.03.036
Subject(s) - medicine , odds ratio , confidence interval , tertiary care , observational study , apgar score , logistic regression , cesarean delivery , obstetrics , emergency medicine , prospective cohort study , multivariate analysis , pregnancy , pediatrics , gestational age , biology , genetics
Objective To determine the decision‐to‐delivery interval (DDI) for emergency cesarean deliveries (CDs) at a tertiary center in Nigeria, to evaluate causes of delay, and to assess the effects of delays on perinatal outcomes. Methods Between September and November 2010, a prospective, observational study was undertaken at University College Hospital, Ibadan. Events that occurred after a decision to perform an emergency CD were recorded. Associations between outcomes and the DDI were analyzed. Results Among 235 emergency CDs included, 5 (2.1%) occurred within 30 minutes and 86 (36.6%) within 75 minutes. The mean DDI was 119.2 ± 95.0 minutes. Among CDs with a DDI of more than 75 minutes, logistic factors were the reason for delay in 65 (43.6 %) cases. No significant associations were recorded between DDI and the 5‐minute Apgar score, admission to the special‐care baby unit, or perinatal mortality ( P > 0.05 for all). In multivariate analysis, neonates delivered after 75 minutes were significantly less likely to die during the perinatal period than were those delivered within this period (odds ratio 0.13, 95% confidence interval 0.03–0.66; P = 0.01). Conclusion Institutional delays in CDs need to be addressed. However, the DDI could be less important for perinatal outcome than are some other factors, such as the severity of the indication.