Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia.
PLoS One. 2021 Nov 8;16(11):e0258742. doi: 10.1371/journal.pone.0258742. eCollection 2021.
The National guidelines of most developed countries suggest a target of 30 minutes of the decision to delivery interval for emergency cesarean section. Such guidelines may not be feasible in poorly resourced countries and busy obstetric settings. It is generally accepted that the decision to delivery interval should be kept to the minimum time achievable to prevent adverse outcomes. Therefore, this study aimed to determine the average decision to delivery interval and its effect on perinatal outcomes in emergency cesarean section.
A prospective cohort study was conducted from May to July 2020 at Bahir Dar City Public Hospitals. A total of 182 participants were enrolled, and data were collected using a structured and pre-tested questionnaire. A systematic sampling technique was applied to select the study subjects. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to identify predictors of outcome variables, and variables with a p-value of <0.05 were considered statistically significant.
The average decision to delivery interval was 43.73 ±10.55 minutes. Anesthesia time [AOR = 2.1, 95%CI = (1.3-8.4)], and category of emergency cesarean section [AOR = 3, 95% CI = (2.1-11.5)] were predictors of decision to delivery interval. The prolonged decision to delivery interval had a statistically significant association with composite adverse perinatal outcomes (odds ratio [OR] = 1.8, 95% confidence interval [CI] = (1.2-6.5).
The average decision to delivery interval was longer than the recommended time. It should always be considered an important factor contributing to perinatal outcomes. Therefore, to prevent neonatal morbidity and mortality, a time-dependent action is needed.
大多数发达国家的国家指南建议紧急剖宫产的决策到分娩间隔时间目标为 30 分钟。在资源匮乏的国家和繁忙的产科环境中，此类指南可能不可行。人们普遍认为，应将决策到分娩的间隔时间保持在可实现的最短时间内，以防止不良结局。因此，本研究旨在确定紧急剖宫产的平均决策到分娩间隔时间及其对围产儿结局的影响。
2020 年 5 月至 7 月在巴赫达尔市公立医院进行了一项前瞻性队列研究。共纳入 182 名参与者，使用结构化和预测试问卷收集数据。采用系统抽样技术选择研究对象。数据清理后输入 Epi-Data 版本 4.6 并导出到 SPSS 版本 25 软件进行分析。采用逻辑回归分析确定结局变量的预测因素，具有<0.05 的 p 值被认为具有统计学意义。
平均决策到分娩间隔时间为 43.73±10.55 分钟。麻醉时间 [AOR = 2.1，95%CI = (1.3-8.4)]和紧急剖宫产类别 [AOR = 3，95%CI = (2.1-11.5)]是决策到分娩间隔时间的预测因素。较长的决策到分娩间隔时间与复合不良围产儿结局有统计学显著关联（比值比 [OR] = 1.8，95%置信区间 [CI] = (1.2-6.5)）。
平均决策到分娩间隔时间长于推荐时间。它应该始终被视为影响围产儿结局的重要因素。因此，为了预防新生儿发病率和死亡率，需要采取一种时间依赖性的行动。
