The decision-to-delivery interval in emergency Caesarean sections and its correlation with perinatal outcome: evidence from 204 deliveries in a developing country

Abstract

The international standard decision-to-delivery interval (DDI) for emergency Caesarean sections (CSs) is ≤ 30 minutes but there is little evidence to support this recommendation. The aim of this study was to evaluate DDI for emergency CS and its relationship to perinatal outcome. We undertook a prospective observational study of consecutive cases of emergency CS. Perinatal outcomes were recorded as: Apgar score; neonates requiring admission; and perinatal deaths. The relation between DDI and perinatal outcome was analysed using chi-square and one way analysis of variance (ANOVA). Of 204 pregnancies observed, 19% of deliveries were achieved in ≤ 30 minutes. The mean DDI was 42.5 ± 19.4 minutes. There was no difference between the perinatal outcome for babies with DDI of ≤ 30 versus 31-60 minutes. There was a significantly higher risk of poor perinatal outcome for babies with DDI > 60 minutes. The perinatal outcome between DDI of ≤ 30 and 31-60 minutes was statistically not different. However, the ≤ 30 minutes DDI should remain the gold standard.