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Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study.

ABSTRACT: BACKGROUND:Category-1 emergency caesarean section delivery is the commonly performed surgical procedure in pregnant women associated with significant mortality and morbidity both in the mother and fetus. The decision to delivery time interval is recommended to be less than 30?min by the Royal College of Obstetricians and Gynecologists as well as the American College of Obstetricians and Gynecologists. This study was designed to evaluate the decision to delivery time interval and its effect on feto-maternal outcomes and the associated factors during category-1 emergency caesarean section deliveries. METHOD:A prospective observational cohort study was conducted from March to May 2018 at the University of Gondar Comprehensive Specialized Hospital obstetrics Operation Theater and postnatal ward. A total of 163 clients who were undergone category-1 emergency caesarean section were included in this study. Statistical analysis was performed using SPSS version 20 (IBM Corporate). Bivariate and multivariate logistic regression with a 95% confidence interval was used to determine the association of decision to delivery time interval with predictor variables and feto-maternal outcomes. RESULTS:Only 19.6% of women had a decision to delivery time interval below 30?min. The average decision to delivery time interval was 42?±?21.4?min, the average time from the decision of category-1 emergency caesarean section arrival to the operation theater was 21.58?±?19.76?min and from theater to delivery of anesthesia was 11.5?±?3.6?min. Factors that were associated with prolonged decision to delivery time interval were: time taken to collect surgical materials (AOR?=?13.76, CI?=?1.12-168.7), time taken from decision and arrival to the operation theater (AOR?=?0.75, CI?=?0.17-3.25) and time taken from arrival at the operation theater to the immediate start of skin incision (AOR?=?0.43, CI?=?0.28-0.65). CONCLUSION:Delivery was not achieved within the recommended time interval in the majority of category-1 emergency caesarean sections. The average decision to delivery time interval was longer than the recommended time but it did not affect feto-maternal outcomes.

SUBMITTER: Temesgen MM

PROVIDER: S-EPMC7077147 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study.

Temesgen Mamaru Mollalign MM Gebregzi Amare Hailekirose AH Kasahun Habtamu Getinet HG Ahmed Seid Adem SA Woldegerima Yophtahe Berhe YB

BMC pregnancy and childbirth 20200317 1

<h4>Background</h4>Category-1 emergency caesarean section delivery is the commonly performed surgical procedure in pregnant women associated with significant mortality and morbidity both in the mother and fetus. The decision to delivery time interval is recommended to be less than 30 min by the Royal College of Obstetricians and Gynecologists as well as the American College of Obstetricians and Gynecologists. This study was designed to evaluate the decision to delivery time interval and its effe ...[more]

PMID: 32183720

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Project description:Background:Caesarean section rates have increased worldwide in recent decades. Caesarean section is an essential maternal healthcare service. However, it has both maternal and neonatal adverse outcomes. Therefore this systematic review and meta-analysis aimed to estimate the prevalence, indication, and outcomes of caesarean section in Ethiopia. Methods:Twenty three cross-sectional studies with a total population of 36,705 were included. Online databases (PubMed/Medline, Hinari, Web of Science, and Google Scholar) and online university repository was used. All the included papers were extracted and appraised using the standard extraction sheet format and Joanna Briggs Institute respectively. The pooled prevalence of the caesarean section, indications, and outcomes was calculated using the random-effect model. Result:The overall pooled prevalence of Caesarean section was 29.55% (95% CI: 25.46-33.65). Caesarean section is associated with both maternal and neonatal complications. Cephalopelvic disproportion [18.13%(95%CI: 12.72-23.53] was the most common indication of Caesarean section followed by non-reassuring fetal heart rate pattern [19.57% (95%CI: 16.06-23.08]. The common neonatal complications following Caesarean section included low APGAR score, perinatal asphyxia, neonatal sepsis, meconium aspiration syndrome, early neonatal death, stillbirth, and prematurity whereas febrile morbidity, surgical site infection, maternal mortality, severe anemia, and postpartum hemorrhage were the most common maternal complications following Caesarean section. Conclusion:In this systematic review and meta-analysis, the rate of Cesarean section was high. Cephalopelvic disproportion, low Apgar score, and febrile morbidity were the most common indication of Caesarean section, neonatal outcome and maternal morbidity following Caesarean section respectively. Increasing unjustified Caesarean section deliveries as a way to increase different neonatal and maternal complications, then several interventions needed to target both the education of professionals and the public.

Project description:BACKGROUND:Maternal perceptions about caesarean section contribute to delayed presentation of women for emergency obstetric care. This increases the risks of perinatal and neonatal mortality and slows down the reductions needed to achieve the sustainable development goal (SDG) target of reducing neonatal mortality and ending new-born deaths. The aim of the study is to determine maternal perceptions about caesarean section deliveries and their role in reducing neonatal mortality at a regional and a district hospital in the Upper West Region of Ghana. METHODS:This descriptive study was carried out at two hospitals in the Upper West Region, the most rural region in Ghana, between 15th January and 29th June, 2018. Maternal perceptions were examined among antenatal care attendants at the Upper West Regional Hospital (UWRH) and St Joseph's Hospital Jirapa (SJH), a district hospital, using questionnaires administered by trained nurses. RESULTS:Altogether, 416 completed questionnaires were obtained, comprising 206 from expectant women attending the UWRH and 210 from SJH. Although the majority of women in this study preferred spontaneous vaginal delivery (87.4%, n?=?348) to caesarean section, most of the respondents (n?=?281, 73%) indicated their willingness to have a caesarean section if necessary. The main reason for not wanting a CS was the long recovery time (51.8%, n?=?148). Almost half of women interviewed, representing 45.1% (180) did not know or feel that CS can promote child survival and about a fifth, 21.6% (85) believed that CS can have adverse effects on child survival. Factors associated with poor perception of CS included, no formal education, age less than 19?years and no employment. CONCLUSION:Majority of women in this study had a positive attitude towards the uptake of CS if it becomes necessary. Lack of formal education, age less than 19?years and unemployment are associated with poor maternal perception of CS. Education to improve the perception of CS as a promoter of child survival is necessary and to discourage perceptions that it causes adverse perinatal or neonatal outcome particularly in at risk populations.

Project description:BACKGROUND:Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women's psychosocial outcomes of EmCS worldwide. METHODS:The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women's psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. RESULTS:In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. CONCLUSIONS:EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.

Dataset Information

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study.

Publications

Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study.

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