Emergency sections - how fast?

ISSN 0256-5004 (Print)

By Jean Robinson

AIMS Journal 2001, Vol 13, No 2

How long does it take to do an emergency caesarean? Two doctors in Leicester looked at records for 142 emergency sections to see how long it took from the time the decision was taken to do a section and the actual time of delivery. [1]

Only 26% were started within 30 minutes of the decision. There were no differences in fetal outcome between those delivered within 30 minutes and those where it took longer. However for the 41 sections done for fetal distress, more rapid delivery made a difference. Those babies who had to wait more than 30 minutes were five times more likely to need intubation and were twice as likely to be admitted to intensive care.

They suggest a prospective study of adequate size.

AIMS Comment

Our thanks to the authors for adding to the literature on this important topic, although unfortunately their work is published only in summary. It does, however, beg the question of why outcomes were apparently measured only in plus or minus 30 minutes, and not in smaller units of time.

The last Confidential Enquiry into Stillbirths and Deaths in Infancy [2] found there was a problem in communication as to how urgently a section was needed and this had led to some deaths.

Ten years ago Oxford researchers looked at outcomes of 104 emergency sections for fetal distress. 41% of the labours had been induced. They found that 10 minutes was the ideal time for babies to be in the best condition, and every additional 10 minutes increased their risk of needing special care for asphyxia [3]. Over 40 years ago another study suggested delays of more than 15 minutes added to the risk of asphyxia. [4] Despite those findings there has been an (un)surprising lack of enthusiasm from obstetricians to do further research.

References

1. Akad A and Bosio P, Decision-delivery interval for emergency caesarean section in term pregnancy, J Ob Gyn, 2001; 21(Suppl): S44.

2. CESDI 7th Annual Report. Maternal and Child Health Research Consortium, 2000 p.47.

3. Dunphy C, et al, Caesarean section for fetal distress, the interval from decision to delivery and the relative risk of poor neonatal condition, J Ob Gyn, 1991, 11: 241-244.

4. Choate J and Lund C, Emergency caesarean section. An analysis of maternal and fetal results in 177 operations, Am J Ob Gyn, 1968; 100: 703-14.

Latest Content

Journal

« »

Reviews: Trust your Body, Trust you…

Complete list of book reviews on the AIMS website Trust your Body, Trust your Baby: How learning to listen changes everything Why Mothers' Medication Matters Trust your B…

Read more

Conference Report: Doula UK 2018 Co…

AIMS Journal, Vol 29, No 4 By Jo Dagustun Wow – what another great conference put on by the team at Doula UK! I was keen to get to this annual conference again, having be…

Read more

Babywearing Twins and Multiples: Ho…

AIMS Journal, 2017, Vol 29 No 4 Nicola Lawson shares her knowledge on carrying one - two - three babies! The idea of transporting two babies at once can be daunting, and…

Read more

Events

« »

MBRRACE-UK ‘Saving Lives, Improving…

To register your interest please email conference@npeu.ox.ac.uk or keep an eye on our website https://www.npeu.ox.ac.uk/mbrrace-uk/bookings . Earlybird bookings will open…

Read more

Midwifery Today Conference “Birthin…

17–21 October 2018 Further Details

Read more

AIMS AGM

AIMS AGM 2018 All members welcome! Please email secretary@aims.org.uk if you plan to attend to help us to judge numbers, or if you wish to send apologies 10 for 10.30 sta…

Read more

Latest Campaigns

« »

Press Release: Jeremy Hunt announce…

AIMS is delighted that the Government has recognised the importance to the safety of women and babies of the continuity of carer model of midwifery. Having a midwife that…

Read more

Dr. Ágnes Geréb, Hungarian Midwife…

Dr. Ágnes Geréb is a Hungarian obstetrician and midwife who has been under house arrest following her support for women outside of the obstetric system. March 2018: ENCA…

Read more

"Promoting professionalism, reformi…

AIMS submitted our response to this consultation on the 23 January 2018. A number of regulators, including the Care Quality Commission (CQC), the Professional Standards A…

Read more