Emergency Caesarean Section Influences on the Decision-to-Delivery Interval.pdfVIP

Hindawi Publishing Corporation Journal of Pregnancy Volume 2011, Article ID 640379, 6 pages doi:10.1155/2011/640379 Clinical Study Emergency Caesarean Section: Influences on the Decision-to-Delivery Interval Aiste Cerbinskaite, Sarah Malone, Jennifer McDermott, and Andrew D. Loughney Women’s Services, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne NE1 4LP, UK Correspondence should be addressed to Andrew D. Loughney, andrew.loughney@nuth.nhs.uk Received 18 February 2011; Accepted 12 May 2011 Academic Editor: Tamas Zakar Copyright © 2011 Aiste Cerbinskaite et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. RCOG/NICE guidelines recommend that, for fetal compromise in labour, delivery should be accomplished ideally within 30 minutes. In this study, we investigated the factors which affect the decision-to-delivery (DD) intervals for emergency caesareans. To achieve this, prospective data were collected for all grade 1 and 2 caesareans performed on a busy labour ward over 12 months. We found that the ratio of labouring women to midwives had a significant effect on the DD intervals, which were significantly prolonged when 1 : 1 care was not provided (P 0.001). The observed effect resulted exclusively from a prolonged transfer time to theatre. General anesthesia use shortened the DD interval for grade 1 caesareans (P 0.001) and was more likely to be used during the day shift (P 0.009). We conclude that midwifery staffing levels and the form of anaesthesia employed influence on DD intervals for the most urgent caesarean sections. 1. Introduction