title: The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?
abstract: OBJECTIVE
  To evaluate whether a 30-minute decision-to-delivery interval is a realistic target for emergency caesarean section.
  
  
  METHODS
  An audit of all emergency caesarean sections over five separate periods.
  
  
  METHODS
  A district general hospital.
  
  
  METHODS
  Five groups of women (343 women) with an indication for emergency caesarean section.
  
  
  METHODS
  Following an initial survey, a structured time sheet was introduced, followed by four other surveys to complete the audit cycle.
  
  
  METHODS
  The proportion of caesarean sections where the decision-to-delivery interval was achieved within 30 minutes. The reasons for delay.
  
  
  RESULTS
  In the first survey of 73 emergency caesarean sections, the time to deliver the infant exceeded 30 minutes in 47 women (64%). The main sources of delay were transferring the women to the operating theatre and starting the anaesthetic. After the introduction of a structured time sheet, there was an improvement with each survey, but the target of 30 minutes was reached in only 71% of caesarean sections in the final survey.
  
  
  CONCLUSIONS
  The introduction of a time sheet can improve the decision-to-delivery interval for emergency caesarean section; however, a universal standard of 100% in 30 minutes is unrealistic.
authors.affiliation: Department of Obstetrics, Gravesend and North Kent Hospital, UK.
authors.forename: W H
authors.initials: WH
authors.lastname: Helmy
authors.forename: A S
authors.initials: AS
authors.lastname: Jolaoso
authors.forename: O O
authors.initials: OO
authors.lastname: Ifaturoti
authors.forename: S A
authors.initials: SA
authors.lastname: Afify
authors.forename: M H
authors.initials: MH
authors.lastname: Jones
mesh_terms: D002585:Cesarean Section / Q000379:methods*; D003657:Decision Making; D004630:Emergencies; D005260:Female; D005865:Gestational Age; D006801:Humans; D008485:Medical Audit; D011247:Pregnancy; D011273:Pregnancy, Prolonged; D013997:Time Factors