Hussein Beker Ahmed, Damtew Beyene Sisay, Abdi Hinsermu Bayu, Gudayu Temesgen Worku
Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia.
Department of Clinical Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Womens Health. 2024 Feb 9;16:249-264. doi: 10.2147/IJWH.S436755. eCollection 2024.
The decision to delivery time is the interval between the decision and the childbirth by emergency caesarean delivery. The Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists recommend that the decision to delivery time interval is less than 30 min. Additionally, the decision to delivery time varies across institutions and countries.
The aim of this study was to determine the decision to delivery time and its predictors among women who underwent emergency cesarean delivery at selected hospitals of Northwest Ethiopia, 2023.
An institutional-based prospective cohort study was conducted at selected hospitals of Northwest Ethiopia, among women who underwent emergency cesarean delivery from November 1 to January 30, 2023. A total of 285 participants were enrolled, and data collected using structured and pre-tested questionnaires. A systematic sampling technique was used. Data were entered into Epi-Data version 4.6 and then exported to STATA 15 for further analysis. The log rank test was utilized to compare group differences. The time is estimated by using the Kaplan-Meier curve and Cox proportional-hazard regression analysis was carried out to determine the predictors.
From 285 participants, 56 (21.8%) women delivered within the recommended 30 min. The overall median survival time was undetermined and the restricted mean survival time was 48.9 min (95% CI: 47.4-50.5). The average decision to delivery time is affected among women who hesitate to accept consent (AHR: 0.17, 95% CI: 0.02-1.25), cord prolapses (AHR: 1.36, 95% CI: 0.46-3.94), rank of surgeon (AHR: 0.42. 95% CI: 0.42-1.08), no free operation room table (AHR: 0.27, 95% CI: 0.28-0.94), regional anesthesia (AHR: 0.56, 95% CI: 0.25-1.28), and use of a bladder flap (AHR: 0.33, 95% CI: 0.16-0.85).
Overall decision to delivery times among women who underwent emergency cesarean section at selected hospitals were longer than the recommended time.
决定至分娩时间是指做出决定至通过急诊剖宫产分娩之间的间隔时间。皇家妇产科学院和美国妇产科学院建议决定至分娩时间间隔应小于30分钟。此外，决定至分娩时间在不同机构和国家有所不同。
本研究的目的是确定2023年在埃塞俄比亚西北部选定医院接受急诊剖宫产的女性的决定至分娩时间及其预测因素。
在埃塞俄比亚西北部选定医院开展一项基于机构的前瞻性队列研究，研究对象为2023年11月1日至1月30日期间接受急诊剖宫产的女性。共纳入285名参与者，使用结构化且经过预测试的问卷收集数据。采用系统抽样技术。数据录入Epi-Data 4.6版本，然后导出至STATA 15进行进一步分析。采用对数秩检验比较组间差异。使用Kaplan-Meier曲线估计时间，并进行Cox比例风险回归分析以确定预测因素。
在285名参与者中，56名（21.8%）女性在建议的30分钟内分娩。总体中位生存时间未确定，受限平均生存时间为48.9分钟（95%CI：47.4 - 50.5）。在犹豫是否接受同意的女性（风险比：0.17，95%CI：0.02 - 1.25）、脐带脱垂（风险比：1.36，95%CI：0.46 - 3.94）、外科医生级别（风险比：0.42，95%CI：0.42 - 1.08）、无空闲手术台（风险比：0.27，95%CI：0.28 - 0.94）、区域麻醉（风险比：0.56，95%CI：0.25 - 1.28）以及使用膀胱瓣（风险比：0.33，95%CI：0.16 - 0.85）的女性中，平均决定至分娩时间受到影响。
在选定医院接受急诊剖宫产的女性中，总体决定至分娩时间长于建议时间。
