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Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes
Author(s) -
DOHERTY Dorota A.,
MAGANN Everett F.,
CHAUHAN Suneet P.,
O’BOYLE Amy L.,
BUSCH Jeanne M.,
MORRISON John C.
Publication year - 2008
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2008.00862.x
Subject(s) - medicine , obstetrics , body mass index , apgar score , pregnancy , caesarean section , umbilical cord , fetus , caesarean delivery , anatomy , biology , genetics
Aim: To determine the factors that influence caesarean operative time and operative time effects on pregnancy outcomes. Methods: Prospective observational study of women undergoing a caesarean delivery (CD). Multiple antepartum, intrapartum and neonatal outcomes were assessed for their influence on the time of the CD and the time effect of CD on pregnancy outcomes. Results: There were 386 (23%) caesarean deliveries performed ≤ 30 min, 1070 (65%) between 31 and 60 min, and 200 deliveries ≥ 60 min. Women younger than 18 years ( P = 0.004) and who had caesarean for fetal labor intolerance were associated with shorter operation time ( P < 0.001). Factors associated with an increased operation time were age > 35 years ( P = 0.049), body mass index (BMI) ≥ 30 ( P < 0.001), pre‐existing hypertension ( P = 0.001), prior low segment transverse scar ( P < 0.001), uterus incision other than transverse ( P < 0.001), first‐year resident as primary surgeon ( P < 0.001) and accompanying sterilisation procedure ( P < 0.001). Operation time was significantly related to blood loss ( P < 0.001), likelihood of umbilical artery cord gas pH < 7.1 ( P < 0.001) and Apgar scores at five minutes < 7 ( P = 0.009). Conclusions: Operative time is shortened by age < 18 and delivery for fetal labor intolerance, lengthened by age > 35, BMI > 30, prior caesarean, uterine incision, operating surgeon inexperience and accompanying sterilisation. Increased operative time was linked with an increased blood loss, low five‐minute Apgar scores and umbilical arterial pH < 7.1.