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KMID : 1143220180610010048
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Obstetrics & Gynecology Science
2018 Volume.61 No. 1 p.48 ~ p.55
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Decision-to-delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand
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Khemworapong Khemanat
Sompagdee Nalat
Boriboonhirunsarn Dittakarn
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Abstract
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Objective: To determine the decision-to-delivery interval (DDI) in emergency cesarean delivery and associated factors.
Methods: A total of 431 pregnant women who were indicated for emergency cesarean delivery were included. Clinical information and timing of process after decision until delivery and pregnancy outcomes were evaluated.
Results: Mean age was 30 years, and 59.4% were nulliparous. Mean gestational age at delivery was 37.9 weeks. The decision was made during normal office hour in 33.2%. Median decision-to-operating room interval, decision-to-incision interval, and DDIs were 45, 70, and 82 minutes, respectively. Only 3.5% of patients had DDI ≤30 minutes, while 52.0% had DDI >75 minutes. During after office hours, every time interval was significantly shorter and 4.9% had DDI ≤30 minutes compared to 0.7% in normal office hours (P=0.001). Compared to other indications, time intervals were significantly shorter in those with non-reassuring fetal heart rate (FHR), and DDI ≤30 minutes was achieved in 18.8% vs. 0.8% (P<0.001). Shortest DDI was observed among those with non-reassuring FHR during after office hours. Neonatal outcomes were comparable between different DDIs.
Conclusion: Only 3.5% of emergency cesarean delivery had a DDI ≤30 minutes (median 82 minutes). Significant shorter time intervals were observed in those with non-reassuring FHR during after office hours.
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KEYWORD
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Decision making, Cesarean section, Emergencies
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