A Retrospective Review of Decision to Delivery Time Interval for Foetal Distress at a Central Hospital

The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH). A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesa...

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Published inInternational journal of women's health Vol. 14; pp. 1723 - 1732
Main Authors Khumalo, Motsamai, Leonard, Tristan, Scribante, Juan, Perrie, Helen
Format Journal Article
LanguageEnglish
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Abstract The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH). A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached. During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores. This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.
AbstractList The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH).PurposeThe aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH).A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached.Patients and MethodsA retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached.During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores.ResultsDuring the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores.This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.ConclusionThis study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.
Purpose: The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH). Patients and Methods: A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached. Results: During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores. Conclusion: This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.
The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH). A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached. During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores. This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.
Motsamai Khumalo,1 Tristan Leonard,1 Juan Scribante,2 Helen Perrie1 1Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Surgeons for Little Lives and Department of Pediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCorrespondence: Motsamai Khumalo, Tel +27 82 407 6418, Email rachelkhumalo2008@gmail.comPurpose: The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH).Patients and Methods: A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached.Results: During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores.Conclusion: This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This over-diagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30-minute DDI could have improved outcome.Keywords: decision to delivery time interval, foetal distress, emergency caesarean delivery
Purpose: The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH). Patients and Methods: A retrospective, contextual, descriptive study, using consecutive convenience sampling was done reviewing all the records of emergency caesarean deliveries for foetal distress at CHBAH in February 2019 until a minimum sample size of 385 was reached. Results: During the study period, a total of 617 caesarean deliveries were done, of which 572 (92.7%) were emergencies. Foetal distress accounted for 395 (69.1%) of the emergency caesarean deliveries. No emergency caesarean delivery for foetal distress conformed to the 30-minute DDI and the mean (SD) DDI was 411 (291) minutes. The mean (SD) 5-minute and 10-minute Apgar scores were 8.4 (1.6) and 9.6 (1.3), respectively. There was a significant difference between the type of anaesthetic (general or neuraxial), with those receiving general anaesthesia having shorter anaesthetic start to cut time (p=0.0110). However, those delivered following neuraxial anaesthesia had better 5-minute (p=0.0002) and 10-minute (p=0.0175) Apgar scores. Conclusion: This study showed that a DDI of 30-minutes, was not achieved at CHBAH during the study period. Most babies diagnosed with foetal distress pre-delivery had 5-minute and 10-minute Apgar scores inconsistent with this diagnosis. This overdiagnosis of foetal distress in some cases could have led to delays in delivery of babies who had actual foetal distress and where a 30minute DDI could have improved outcome. Keywords: decision to delivery time interval, foetal distress, emergency caesarean delivery
Audience Academic
Author Scribante, Juan
Perrie, Helen
Khumalo, Motsamai
Leonard, Tristan
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Keywords emergency caesarean delivery
decision to delivery time interval
foetal distress
Language English
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Snippet The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital (CHBAH)....
Purpose: The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital...
The aim of this study was to describe the trajectory of emergency caesarean deliveries for foetal distress at Chris Hani Baragwanath Academic Hospital...
Motsamai Khumalo,1 Tristan Leonard,1 Juan Scribante,2 Helen Perrie1 1Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences,...
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StartPage 1723
SubjectTerms Apgar score
Cesarean section
Data collection
decision to delivery time interval
Eclampsia
emergency caesarean delivery
foetal distress
General anesthesia
Health aspects
Hypoxia
Mothers
Obstetrics
Original Research
Pathogenesis
Placental abruption
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Title A Retrospective Review of Decision to Delivery Time Interval for Foetal Distress at a Central Hospital
URI https://www.ncbi.nlm.nih.gov/pubmed/36540848
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https://pubmed.ncbi.nlm.nih.gov/PMC9760065
https://doaj.org/article/1280b920b38a4506bdce9bd31819e0f0
Volume 14
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