title: Emergency caesarean section: risk factors for adverse neonatal outcome.
abstract: OBJECTIVE
  Primary aim of the study was to identify risk factors for an adverse neonatal outcome in emergency caesarean deliveries (ECD). Secondary, the influence of the decision-to-delivery interval (DDI) on neonatal outcome was evaluated.
  
  
  METHODS
  Study period of this retrospective investigation was 2001-2011, in which 336 ECD were evaluated. Main outcome measures were risk factors associated with an adverse neonatal outcome (umbilical cord arterial pH < 7.05, umbilical cord arterial base excess (BE) < -12, Apgar score at 5 min <5 and the combination of umbilical cord arterial pH < 7.0, and umbilical cord arterial BE < -12). Secondary, the influence of the DDI on neonatal outcome was assessed. These parameters were tested in univariate and multivariate analyses.
  
  
  RESULTS
  Prematurity (<37 + 0 weeks of gestation) and silent cardiotocography (CTG) were identified as the major risk factors for an adverse neonatal outcome. Statistical analyses of the influence of the DDI on umbilical cord arterial pH and BE as well as the Apgar score at 5 min revealed no significant results.
  
  
  CONCLUSIONS
  Our results emphasize the necessity of attendance in a level-3 department of obstetrics in case of conceivable compromised neonatal conditions. Prematurity and silent CTG were identified as the major risk factors for an adverse neonatal outcome. As long as the DDI is under 20 min, it did not have an impact on neonatal outcome.
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Berlit
authors.forename: Grit
authors.initials: G
authors.lastname: Welzel
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tuschy
authors.forename: Jana
authors.initials: J
authors.lastname: Nickol
authors.forename: Amadeus
authors.initials: A
authors.lastname: Hornemann
authors.forename: Marc
authors.initials: M
authors.lastname: Sütterlin
authors.forename: Sven
authors.initials: S
authors.lastname: Kehl
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000009:adverse effects*; D004200:Diseases in Twins; D004638:Emergency Treatment / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014469:Umbilical Arteries