Category-1 caesarean section: a survey of anaesthetic and peri-operative management in the UK.
A national survey of anaesthetic and peri-operative management of category-1 caesarean section was sent to 245 consultant-led maternity units. There was a 70% response rate. The median (IQR [range]) general anaesthetic rate was 51% (29%-80% [6%-100%]), 12% (9%-16% [3%-93%]), 4% (2%-5% [<1%-18%]), for category-1 caesarean section, categories 1-3 (non-elective/emergency) and category-4 (elective) caesarean section, respectively. The main operating theatre for caesarean section is on the delivery suite in 151 (88%) units, and 112 (66%) units also have a second theatre in the same location. One hundred and thirty-nine (81%) use the standard urgency classification described in the NICE caesarean section guideline. However, only 72 (42%), 24 (14%), and 16 (9%) units comply with this guideline's recommended decision-delivery intervals for category-1 (< or = 30 min), category-2 (< or = 30 min) and category-3 (< or = 75 min) caesarean sections, respectively. Practice in the smaller units was similar to that in the larger units, although there was less availability of a dedicated anaesthetist, intra-uterine resuscitation guidelines and operating theatres on the delivery suite in the smaller units.
Kinsella
S M
SM
St Michael's Hospital, Bristol, UK. Stephen.Kinsella@uhbristol.nhs.uk <Stephen.Kinsella@uhbristol.nhs.uk>
Walton
B
B
Sashidharan
R
R
Draycott
T
T
D000765:Anesthesia, Conduction / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D009873:Operating Rooms / Q000458:organization & administration / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011364:Professional Practice / Q000706:statistics & numerical data; D006113:United Kingdom