Outcome differences of emergency cesarean delivery in the delivery room versus the operating room: A study based on propensity score matching.
decision‐to‐delivery interval
delivery room
emergency cesarean section
operating room
propensity score matching
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
25 Oct 2024
25 Oct 2024
Historique:
revised:
28
09
2024
received:
05
08
2024
accepted:
06
10
2024
medline:
25
10
2024
pubmed:
25
10
2024
entrez:
25
10
2024
Statut:
aheadofprint
Résumé
This study sought to compare the risks and outcomes associated with category I cesarean section procedures performed in the delivery room versus those performed in the operating room. The analysis included 126 singleton pregnant women who underwent inpatient delivery at the Second People's Hospital of Nanning between January 2021 and May 2024. Following propensity score matching, 21 cases were in the delivery room group, and 105 cases were in the operating room group. Parameters under investigation encompassed decision-to-delivery interval, incision-to-delivery interval, surgical duration, intraoperative blood loss, postoperative antibiotic duration, postoperative hospital stay length, postoperative fever incidence, adverse neonatal outcomes, and blood routine parameters. The decision-to-delivery interval was significantly shorter in the delivery room group than in the operating room group. Conversely, the delivery room group exhibited longer surgical durations, higher blood loss, prolonged postoperative antibiotic usage, extended hospital stays, and elevated white blood cell counts with statistical significance (p < 0.05). Nevertheless, no notable variations were observed between the groups in maternal and neonatal outcome indicators, such as adverse neonatal outcomes and postoperative fever rates. The outcomes suggest that the delivery room group showed increased risks compared with the operating room group, potentially indicating heightened vulnerabilities to bleeding and infection. Hence, it is advisable for patients to undergo surgery in the operating room unless the delivery room is equipped with sterile surgical facilities or in cases of urgent necessity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 International Federation of Gynecology and Obstetrics. Published by John Wiley & Sons Ltd.
Références
National Center for Healthcare Quality Management in Obstetrics, Chinese Society of Perinatal Medicine, Chinese Medical Association. Expert consensus on cesarean section (2023). Chin J Obstet Gynecol. 2024;59(1):14‐21.
2021 Exceptional Surveillance of Caesarean Birth‐Diamorphine (NICE Guideline NG192). National Institute for Health and Care Excellence (NICE); 2021.
Khemworapong K, Sompagdee N, Boriboonhirunsarn D. Decision‐to‐delivery interval in emergency cesarean delivery in tertiary care hospital in Thailand. Obstet Gynecol Sci. 2018;61(1):48‐55.
Wangwe P, Kibwana M, August F, I Kikula A. Decision to delivery interval, maternal and fetal outcomes in emergency caesarean sections in a tertiary teaching hospital, Dar es salaam, Tanzania. Afr Health Sci. 2023;23(3):17‐26.
Hussein BA, Damtew BS, Abdi HB, et al. Decision to delivery time and its predictors among mothers who underwent emergency cesarean delivery At selected hospitals of Northwest Ethiopia, 2023: prospective cohort study. Int J Womens Health. 2024;16:249‐264.
Hao W, Wang T. Decision‐ to‐ delivery time and feto‐maternal outcomes in emergency cesarean section. Chin J Pract Gynecol Obstet. 2021;37(6):673‐678. doi:10.19538/j.fk2021060117
Liu HX, Xiao HY, Zhang LF, et al. Factors influencing decision‐to‐delivery interval in emergency cesarean section in Guangzhou and its impact on maternal‐infant outcomes. Chin J Perinat Med. 2024;27(5):353‐361.
Jolien J, Yves J. Cesarean section in the delivery room: an exploration of the viewpoint of midwives, anaesthesiologists, and obstetricians. J Pregnancy. 2018;27(2018):1017572.
El‐Achi V, Wan KM, Brown J, et al. Readmissions for surgical site infections following caesarean section. Aust N Z J Obstet Gynaecol. 2018;58(5):582‐585.
Padmakumar AD, Cohen O, Churton A, Groves JB, Mitchell DA, Brennan PA. Effect of noise on tasks in operating theatres: a survey of the perceptions of healthcare staff. Br J Oral Maxillofac Surg. 2017;55(2):164‐167.
Sheridan H, Plaza E, Hendren G, Hu J, Ortman AJ. Noise levels during cesarean delivery: a prospective observational study. Int J Obstet Anesth. 2021;48:103211.
Safety P, Committee Q. Society for Maternal‐Fetal Medicine Special Statement: checklist for initial management of amniotic fluid embolism. Am J Obstet Gynecol. 2021;224(4):B29‐B32.
Peng SM, Zhou W. Implementation of emergency cesarean section during vaginal delivery. Chin J Pract Gynecol Obstet. 2022;38(8):801‐804.
Ayeni OM, Aboyeji AP, Ijaiya MA, Adesina KT, Fawole AA, Adeniran AS. Determinants of the decision‐to‐delivery interval and the effect on perinatal outcome after emergency caesarean delivery: a cross‐sectional study. Malawi Med J. 2021;33(1):28‐36.
Pearson GA, Kelly B, Russell R, Dutton S, Kurinczuk JJ, MacKenzie IZ. Target decision to delivery intervals for emergency caesarean section based on neonatal outcomes and three year follow‐up. Eur J Obstet Gynecol Reprod Biol. 2011;159(2):276‐281.
Temesgen MM, Gebregzi AH, Kasahun HG, Ahmed SA, Woldegerima YB. Evaluation of decision to delivery time interval and its effect on feto‐maternal outcomes and associated factors in category‐1 emergency caesarean section deliveries: prospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):164.
Tolcher MC, Johnson RL, El‐Nashar SA, et al. Decision‐to‐incision time and neonatal outcomes: a systematic review and meta‐analysis. Obstet Gynecol. 2014;123(3):536‐548.
Kasagi Y, Okutani R, Oda Y. Specialized operating room for cesarean section in the perinatal care unit: a review of the opening process and operating room management. J Anesth. 2015;29(1):149‐151.
Iitani Y, Tsuda H, Ito Y, et al. Simulation training is useful for shortening the decision‐to‐delivery interval in cases of emergent cesarean section. J Matern Fetal Neonatal Med. 2018;31(23):3128‐3132.
Xu X, Lin Y, Weng L, Guo Y, Lin L, Yan J. The application of rapid response team in category 1 emergency caesarean section teaching for OBGYN residents in the delivery room. Medicine (Baltimore). 2023;102(35):e34551.
Li Y, Yang C, Yang S, Lan H, Yang D. Analysis of the application effect of a rapid response team in emergency cesarean section. J Matern Fetal Neonatal Med. 2023;36(2):2279025.
Mannella P, Pancetti F, Giannini A, Russo E, Montt‐Guevara M, Simoncini T. Five actions for five people: emergency cesarean section protocol. BMC Pregnancy Childbirth. 2023;23(1):272.
Cornthwaite K, Edwards S, Siassakos D. Reducing risk in maternity by optimising teamwork and leadership: an evidence‐based approach to save mothers and babies. Best Pract Res Clin Obstet Gynaecol. 2013;27(4):571‐581.