Abstract
Many resource-constrained centres fail to meet the international standard of 30min of decision-to-delivery interval (DDI) of Category-1 crash caesarean deliveries. However, specific scenarios like acute foetal bradycardia and antepartum haemorrhage necessitate even faster interventions. A multidisciplinary team developed a "CODE-10 Crash Caesarean" rapid response protocol to limit DDI to 15min. A multidisciplinary committee analysed a retrospective clinical audit of maternal-foetal outcomes over 15months (August 2020-November 2021), and expert recommendations were sought. The median DDI of twenty-five patients who underwent a "CODE-10 Crash Caesarean delivery" was 13 ± 6min, with 92% (23/25) of DDIs falling below 15min. Seven neonates required intensive care for more than 24h with no maternal or neonatal mortality. DDIs during office and non-office hours were not significantly different (12.5 ± 6min vs 13 ± 5min, p = 0.911). Transport delays caused the two instances of DDI > 15min. The novel "CODE-10 Crash Caesarean" protocol may be feasible for adoption in a similar tertiary-care setting with appropriate planning and training.
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