Perinatal Outcome of Women who Delivered within 30 Minutes Versus after 30 Minutes of Taking Decision of an Emergency Cesarean Section
Objectives: To determine perinatal outcome of neonates delivered by ECS and compare with regards to decision time duration of emergency cesarean section (ECS) of ≤ 30 versus > 30 minutes.
Subjects and Methods: This comparative study was done at department of Gynecology and Obstetrics at Liaquat University Hospital Jamshoro from march 2015 to February 2016. Women with age of 18 to 45 years, normal healthy pregnant women with age of 18 to 45 years and gestational age of 37-41 weeks undergoing emergency c-section due to fetal distress (FHR <100 b/m or presence of meconium-stained liquor) were included. Of 202 cases 95 underwent <30 minutes of the decision to delivery interval and 107 underwent >30 minutes of the decision to delivery interval of (ECS). Obstetric and anesthetic consultants were completely involved till the procedure. Perinatal outcome was assessed in terms of NICU admission and still birth. After data collection by study proforma, the SPSS version 26 was used for the analysis.
Results: Overall mean age of the participants was 27.6931±4.85 years, mean gestational age was 37.60±2.18 weeks and operative time was 90.22 mints. Out of all 115(56.9%) patients were booked while 87(43.1%) were un-booked. 93.6% patients had received spinal while 6.4% received general anesthesia. According to the neonatal outcome 73(36.1%) neonates were admitted in NICU while 20(9.9%) babies were born stillbirth. Most of the cases underwent spinal anesthesia in both groups and only 13 patients underwent general anesthesia particularly as 8 patients of <30 minutes group and 5 patients in >30 minutes group (p-279). Findings regarding of all 73 NICU admitted patients and overall, 20 sill birth cases were statistically insignificant (p- >0.05). With respect to the stratification the neonatal outcomes were statistically insignificant according to the parity, booking status and types of anesthesia given, p-values were quite insignificant.
Conclusions: No significant difference in perinatal outcome was observed with in < 30 minutes and > 30 minutes of the decision to delivery interval of emergency cesarean section because in this study majority of women were underwent C section >30 minutes. This may due to most caesarean sections for take longer than 30 minutes. These delays occur due to in getting the patient to theatre, achieving effective anaesthesia and delay in blood donors for blood transfusion.
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