Decision-to-incision times and maternal and infant outcomes.

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Pediatrics; Obstetrics & Gynecology
Creator Varner, Michael W.
Other Author Bloom SL, Leveno KJ, Spong CY, Gilbert S, Hauth JC, Landon MB, Varner MW, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, O'sullivan MJ, Sibai BM, Langer O, Gabbe SG; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Title Decision-to-incision times and maternal and infant outcomes.
Date 2006-07
Description OBJECTIVE: To measure decision-to-incision intervals and related maternal and neonatal outcomes in a cohort of women undergoing emergency cesarean deliveries at multiple university-based hospitals comprising the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. METHODS: All women undergoing a primary cesarean delivery at a Network center during a 2-year time span were prospectively ascertained. Emergency procedures were defined as those performed for umbilical cord prolapse, placental abruption, placenta previa with hemorrhage, nonreassuring fetal heart rate pattern, or uterine rupture. Detailed information regarding maternal and neonatal outcomes, including the interval from the decision time to perform cesarean delivery to the actual skin incision, was collected. RESULTS: Of the 11,481 primary cesarean deliveries, 2,808 were performed for an emergency indication. Of these, 1,814 (65%) began within 30 minutes of the decision to operate. Maternal complication rates, including endometritis, wound infection, and operative injury, were not related to the decision-to-incision interval. Measures of newborn compromise including umbilical artery pH less than 7 and intubation in the delivery room were significantly greater when the cesarean delivery was commenced within 30 minutes, likely attesting to the need for expedited delivery. Of the infants with indications for an emergency cesarean delivery who were delivered more than 30 minutes after the decision to operate, 95% did not experience a measure of newborn compromise. CONCLUSION: Approximately one third of primary cesarean deliveries performed for emergency indications are commenced more than 30 minutes after the decision to operate, and the majority were for nonreassuring heart rate tracings. In these cases, adverse neonatal outcomes were not increased. LEVEL OF EVIDENCE: II-2.
Type Text
Publisher Lippincott, Williams & Wilkins
Volume 108
Issue 1
First Page 6
Last Page 11
Subject Cesarean Section; Fetal Distress; Outcome Assessment; Fetal Distress
Subject MESH Cesarean Section; Fetal Distress; Time Factors
Language eng
Bibliographic Citation Bloom SL, Leveno KJ, Spong CY, Gilbert S, Hauth JC, Landon MB, Varner MW, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, O'sullivan MJ, Sibai BM, Langer O, Gabbe SG; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Decision-to-incision times and maternal and infant outcomes. Obstet Gynecol. 2006 Jul;108(1):6-11. Retrieved on May 25th 2007 from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?orig_db=PubMed&db=PubMed&cmd=Search&term=108%5Bvolume%5D+AND+1%5Bissue%5D+AND+6%5Bpage%5D+AND+2006%5Bpdat%5D+AND+Varner+MW%5Bauthor%5D
Rights Management Copyright © Wolters Kluwer, Obstetrics and Gynecology, 108, 6-11, 2006
Format Medium application/pdf
Identifier ir-main,1594
ARK ark:/87278/s6rb7p89
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2021-05-06
ID 707457
Reference URL https://collections.lib.utah.edu/ark:/87278/s6rb7p89
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