Decision to delivery interval and perinatal outcome for category one caesarean section in a tertiary hospital

Abstract

Background: The Royal college of obstetrics and gynaecology and the American College of Obstetrics and Gynecology recommend a maximum interval of 30 minutes between the decision to perform an emergency caesarean section and delivery of the baby (DDI), when there is an immediate life threatening condition to the mother or baby. So far, this has been a herculean task in the majority of the developing nations.

Objectives: To determine the decision-to-delivery interval and perinatal outcome for category one caesarean section in Aminu Kano Teaching Hospital, Kano.

Methods: A One Year Retrospective study of category one caesarean section performed in Aminu Kano Teaching Hospital between 1st January 2018 and 31st December 2018.

Results: The mean DDI was 114.4 minutes. Only 6.2% were delivered within the recommended 30 minutes DDI. There was no significant association between the DDI and adverse perinatal outcomes but a significant association was found between the indication for the crash caesarean section and adverse perinatal outcome. The major determinants of prolonged DDI were maternity unit delays, anaesthetist delay, patient refusal to sign consent and busy operating rooms.

Conclusion: The mean DDI was longer than the recommended DDI of 30 minutes. Although this had no impact on perinatal outcome in this study. However, the perinatal outcome largely depended on the indication for the caesarean section.