title: Perinatal consequences of a category 1 caesarean section at term.
abstract: OBJECTIVE
  To characterise maternal demographics, obstetric risk factors and neonatal outcomes associated with term category 1 caesarean sections (CS).
  Retrospective study of term singleton pregnancies delivering at a major tertiary unit in Brisbane, Australia. Category 1 CS were defined as one that required a decision-to-delivery time interval of <30 min when there was an immediate threat to the life of a woman or fetus. Neonatal outcomes analysed were gestation at delivery, birth weight, Apgar scores, acidosis at birth, need for resuscitation, admission to neonatal intensive care and neonatal seizures and death.
  
  
  RESULTS
  A total of 30,719 women delivering at term were included. Of these, 1179 (3.8%) women required a category 1 CS. A further 3527 women underwent non-category 1 CS. Most category 1 CS were performed for non-reassuring fetal status (65.9%, 777/1179). The indications for non-category 1 CS were for failure to progress (46.5%, 1641/3527) and non-reassuring fetal status (19%, 671/3527). Maternal age, body mass index and medical disease did not differ significantly between the two cohorts. Caucasian women were equally as likely to undergo a category 1 CS as a non-category 1 CS, while indigenous women and women of Asian ethnicity were more likely to undergo a category 1 CS. Significantly higher (p<0.001) perinatal complications were seen in the category 1 CS cohort--Apgar scores <7 at 1 min (20.4%, 241/1179 vs 10.7%, 377/3527) and 5 min (5.8%, 68/1179 vs 1.9%, 67/3527), umbilical arterial pH<7.2 (23.7%, 279/1179 vs 9.1%, 321/3527), neonatal resuscitation (59.9%, 706/1179 vs 51.8%, 1828/3527), neonatal intensive care unit admission (9.8%, 116/1179 vs 2.5%, 87/3527) and seizures (0.8%, 10/1179 vs 0.3%, 9/3527), respectively.
  
  
  CONCLUSIONS
  These results demonstrate significantly poorer outcomes associated with term category 1 CS compared with non-category 1 emergency CS.
authors.affiliation: Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
authors.forename: Leah
authors.initials: L
authors.lastname: Grace
authors.affiliation: Mater Research Institute-University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: Ristan M
authors.initials: RM
authors.lastname: Greer
authors.affiliation: Mater Mothers' Hospital, South Brisbane, Queensland, Australia Mater Research Institute-University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D001034:Apgar Score; D001315:Australia; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D011247:Pregnancy; D012189:Retrospective Studies; D047929:Term Birth; D062606:Tertiary Care Centers