评估紧急剖宫产的决策至分娩间隔及其对新生儿结局的影响。
Evaluating the Decision-to-Delivery Interval in Emergency Cesarean Sections and its Impact on Neonatal Outcome.
机构信息
Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, Cologne, Germany
Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, Cologne, Germany.
出版信息
In Vivo. 2020 Nov-Dec;34(6):3341-3347. doi: 10.21873/invivo.12172.
BACKGROUND/AIM: In Germany, performance of an emergency Cesarean section (ECS) is recommended within an interval of ≤20 min from decision to delivery (DDI). The aim of the study was to assess the duration of DDI in ECS as well as its impact on neonatal outcome.
PATIENTS AND METHODS
Data from 437 patients at a single, tertiary care hospital were retrospectively analysed regarding influence on the duration of DDI. Subsequently the impact of DDI on neonatal outcome and incidence of adverse neonatal outcome was analysed.
RESULTS
DDI of ECS performed outside core working hours was significantly prolonged (p<0.001). Shorter DDI showed a statistically worse arterial cord blood pH (p=0.001, r=0.162) and base excess (p=0.05; r=0.094). Duration of DDI had no significant impact on the incidence of adverse neonatal outcome (p=0.123).
CONCLUSION
Awareness of influence on DDI might contribute to expediting DDI, but duration of DDI showed no impact on the incidence of adverse neonatal outcome. Data were not adequate to suggest a recommendation for DDI time standards.
背景/目的：在德国，建议紧急剖宫产（ECS）的决策至分娩时间（DDI）间隔应≤20 分钟。本研究旨在评估 ECS 的 DDI 持续时间及其对新生儿结局的影响。
患者和方法
对一家三级保健医院的 437 例患者的数据进行回顾性分析，以评估其对 DDI 持续时间的影响。随后分析 DDI 对新生儿结局和不良新生儿结局发生率的影响。
结果
核心工作时间之外进行的 ECS 的 DDI 明显延长（p<0.001）。较短的 DDI 显示出统计学上更差的动脉脐带血 pH 值（p=0.001，r=0.162）和碱剩余（p=0.05；r=0.094）。DDI 的持续时间对不良新生儿结局的发生率没有显著影响（p=0.123）。
结论
对 DDI 影响的认识可能有助于加快 DDI，但 DDI 的持续时间对不良新生儿结局的发生率没有影响。数据不足以建议制定 DDI 时间标准。
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