Decision-to-Icision Times And Maternal And Infant Outcomes

Objective:To measure decision-to-incision intervals and related maternal andneonatal outcomes in a cohort of women undergoing emergency cesarean deliveriesat a teaching hospital.Methods:All women undergoing a primary cesarean delivery at a teaching hospitalduring a 6-year time span were prospectively ascertained. Emergency procedureswere defined as those performed for umbilical cord prolapse,placentalabruption,placenta previa with hemorrhage,nonreassuring fetal heart ratepattern,dystocia in cephalic presentation.Detailed information regarding maternal andneonatal outcomes,including the interval from the decision time to perform cesareandelivery to the actual skin incision,was collected.Results:735 were performed for an emergency indication.Of theseonly1 .2%began within 30 minutes of the decision to operate.maternalcomplication,including endometitis,operative injury,were not happen. Compared withbabies delivered within 75 minutes,there was no difference in maternal or babyoutcome for decision to incision interval more than 75 minutes.Conclusions:In this hospital,almost all primary cesarean delivery performed morethan 30 minutes for emergency indications to operate,and the majority were fornonreassuring heart rate tracings and dystocia in cephalic presentation.Decision toincision intervals of more than 75 minutes are not associated with poorer maternal andbaby outcomes .