title: Emergency caesarean section: influences on the decision-to-delivery interval.
abstract: RCOG/NICE guidelines recommend that, for fetal compromise in labour, delivery should be accomplished ideally within 30 minutes. In this study, we investigated the factors which affect the decision-to-delivery (DD) intervals for emergency caesareans. To achieve this, prospective data were collected for all grade 1 and 2 caesareans performed on a busy labour ward over 12 months. We found that the ratio of labouring women to midwives had a significant effect on the DD intervals, which were significantly prolonged when 1 : 1 care was not provided (P < 0.001). The observed effect resulted exclusively from a prolonged transfer time to theatre. General anesthesia use shortened the DD interval for grade 1 caesareans (P < 0.001) and was more likely to be used during the day shift (P < 0.009). We conclude that midwifery staffing levels and the form of anaesthesia employed influence on DD intervals for the most urgent caesarean sections.
authors.affiliation: Women's Services, Royal Victoria Infirmary, Richardson Road, Newcastle upon Tyne NE1 4LP, UK.
authors.forename: Aiste
authors.initials: A
authors.lastname: Cerbinskaite
authors.forename: Sarah
authors.initials: S
authors.lastname: Malone
authors.forename: Jennifer
authors.initials: J
authors.lastname: McDermott
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Loughney
mesh_terms: D039602:After-Hours Care / Q000706:statistics & numerical data; D000704:Analysis of Variance; D000758:Anesthesia / Q000379:methods / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000592:standards / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006801:Humans; D008880:Midwifery / Q000458:organization & administration*; D061646:Operative Time; D010561:Personnel Staffing and Scheduling; D011247:Pregnancy; D013997:Time Factors; D014187:Transportation of Patients; D016526:Workload / Q000706:statistics & numerical data