Kaukab Tashfeen
Specialist at Sohar Hospital Oman, Sultanate of OmanPresentation Title:
Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases Repeated cross-sectional study from Oman
Abstract
Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes.
Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audits cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of <7 at five minutes, admission to the Special Care Baby Unit (SCBU) or a stillbirth.
Results: In the initial cycle, a DDI of ≤30 minutes was achieved in 23.8% of 84 cases in comparison to 44.6% of 83 cases in the second cycle. In the third cycle, 60.8% of 79 women had a DDI of ≤30 minutes (P <0.001). No significant differences in perinatal outcomes for cases with a DDI of ≤30 minutes versus 31–60 minutes were observed; however, a DDI of >60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each). Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre.
Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes.
Keywords: Obstetric Delivery; Medical Decision-Making; Cesarean Section; Clinical Audit; Fetal Death; Apgar Score; Oman.
Biography
Kaukab Tashfeen has completed her postgraduation from Dublin Ireland in 2014 and completed postgraduation from Pakistan in 2007, She has multiple publication, published in Oman Medical Journal and Sultan Qaboos University Journal. She is committed to providing care that respects patient autonomy and ethical standards. In addition, she is Leading and mentoring junior medical staff, including residents and medical students.
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