title: The 30-minute decision-to-incision interval for emergency cesarean delivery: fact or fiction?
abstract: The objective of this study was to evaluate the effect of the current guideline of 30-minute decision-to-incision interval (D-I) in emergent cesarean delivery (ECD) on neonatal and maternal outcomes. A retrospective chart review was conducted of pregnant women who underwent ECDs between January 1999 and December 2001. The overall median D-I was 20 minutes (range, 5 to 57 minutes). In 83 women (group I), D-I was < or = 30 minutes, and in 28 women (group II), it exceeded 30 minutes. Group I had more neonates with cord pH < 7.00, seizures, encephalopathy, and lower Apgar scores at 1 and 5 minutes than group II, but were not statistically significant. There was no significant difference in neonatal admission to the neonatal intensive care unit or length of stay between the two groups. Maternal complications were higher in group I, but not statistically significant. Although it was achieved in most of the ECDs, the guideline of 30-minute D-I does not seem to improve neonatal nor worsen maternal outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77555-0587, USA.
authors.forename: Fayez K
authors.initials: FK
authors.lastname: Nasrallah
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Harirah
authors.forename: Rakesh
authors.initials: R
authors.lastname: Vadhera
authors.forename: Venu
authors.initials: V
authors.lastname: Jain
authors.forename: Letitia T
authors.initials: LT
authors.lastname: Franklin
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003657:Decision Making; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay; D008499:Medical Records; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D013996:Time and Motion Studies