ORIGINAL ARTICLE

Decision to Delivery Interval in Emergency Cesarean Section at Two Academic Hospitals in Yogyakarta and Central Java, Indonesia

Shinta Prawitasari , Doni Widyandana, Mohammad Hakimi, Adi Utarini

Shinta Prawitasari
Department of Obstetrics and Gynecology Faculty of Medicine, Nursing and Public Health Universitas Gadjah Mada. Email: [email protected]

Doni Widyandana
Department of Medical Education Faculty of Medicine, Nursing and Public Health Universitas Gadjah Mada

Mohammad Hakimi
Department of Obstetrics and Gynecology Faculty of Medicine, Nursing and Public Health Universitas Gadjah Mada

Adi Utarini
Health Policy and Management Department Faculty of Medicine, Nursing and Public Health Universitas Gadjah Mada
Online First: April 01, 2021 | Cite this Article
Prawitasari, S., Widyandana, D., Hakimi, M., Utarini, A. 2021. Decision to Delivery Interval in Emergency Cesarean Section at Two Academic Hospitals in Yogyakarta and Central Java, Indonesia. Bali Medical Journal 10(1): 266-272. DOI:10.15562/bmj.v10i1.2030


Background: The international guideline suggests that the ideal DDI is 30 minutes for grade 1 and grade 2 CS, but they are still hardly achieved. Therefore, the main purpose of this study was to determine the DDI for grade 1 and 2 CS, and its determinants in two academic hospitals.

Methods: A prospective cohort study was conducted using pregnant women who underwent grade 1 and 2 emergency CS. Data regarding demographic characteristics of the subjects were extracted from the medical record, while DDI and its components were measured by direct observation. Odds ratio was used to determine the association between DDI and its determinants.

Results: The median DDI for grade 1 and 2 CS in the main academic hospital were 112.5 minutes and 181 minutes respectively, longer than their duration in the affiliated hospital with 80 minutes for grade 1 CS and 104 minutes for grade 2 CS. The significant determinants for a 75-minute DDI in the main academic hospital were grade of CS (OR: 0.12; 95%CI: 0.01-1.05; p: 0.047), indication of CS (OR: 0.77; 95%CI: 0.6-0.89; p: 0.014), and anesthesiologist response time (OR: 9.18; 95%CI: 2.21-38.13; p: 0.001), while in the affiliated academic hospital, operating room waiting time was the only significant determinants (OR: 6.18; 95%CI: 2.07-18.48; p: 0.001).

Conclusions: DDI for emergency CS still exceeded the standard in academic hospitals with different determinants causing the delay. Strengthening interprofessional collaboration should be implemented systematically.  

References

Thomas J, Paranjothy S, James D. National cross sectional survey to determine whether the decision to delivery interval is critical in emergency Cesarean Section. Br Med J. 2004;328(7441):665-668. doi:10.1136/bmj.38031.775845.7c

Bloom SL, Leveno KJ, Spong CY, et al. Decision-to-incision times and maternal and infant outcomes. Obstet Gynecol. 2006;108(1):6-11. doi:10.1097/01.AOG.0000224693.07785.14

Leung TY, Lao TT. Best Practice & Research Clinical Obstetrics and Gynaecology Timing of Cesarean Section according to urgency. YBEOG. 2013;27(2):251-267. doi:10.1016/j.bpobgyn.2012.09.005

Kamotho D, Pertet AM, Ogwayo I. Decision to incision interval for emergency Cesarean Section and postoperative outcomes in a resource limited rural Kenyan public hospital. Int J Reprod Contraception, Obstet Gynecol. 2018;7(7):2573. doi:10.18203/2320-1770.ijrcog20182863

Gupta S, Naithani U, Madhanmohan C, Singh A, Reddy P, Gupta A. Evaluation of decision-to-delivery interval in emergency cesarean section: A 1-year prospective audit in a tertiary care hospital. J Anaesthesiol Clin Pharmacol. 2017;33(1):64-70. doi:10.4103/0970-9185.202197

Tuffnell DJ, Wilkinson K, Beresford N. Interval between decision and delivery by Cesarean Section—are current standards achievable? Observational case series. Bmj. 2001;322(7298):1330-1333. doi:10.1136/bmj.322.7298.1330

Denison FC, Hughes RG, Sargent L, Calder AA. Cesarean Section Audit. Vol 23.; 2003. doi:10.1080/718591762

Gunawan T, Attamimi A, Pradjatmo H. Hubungan Response Time Seksio Sesarea Emergensi Kategori 1 dengan Luaran Perinatal di RSUP Dr.Sardjito. J Kesehat Reproduksi. 2018;5(1):60. doi:10.22146/jkr.37997

Hirani BA, Mchome BL, Mazuguni NS, Mahande MJ. The decision delivery interval in emergency Cesarean Section and its associated maternal and fetal outcomes at a referral hospital in northern Tanzania: a cross-sectional study. BMC Pregnancy Childbirth. 2017;17(1):411. doi:10.1186/s12884-017-1608-x

Radhakrishnan G, Yadav G, Vaid N, Ali H. Factors affecting “decision to delivery interval” in emergency Cesarean Sections in a tertiary care hospital: a cross sectional observational study. Int J Reprod Contraception, Obstet Gynecol. 2013;2(4):651. doi:10.5455/2320-1770.ijrcog20131231

Kolås T, Hofoss D, Øian P. Predictions for the decision-to-delivery interval for emergency cesarean sections in Norway. Acta Obstet Gynecol Scand. 2006;85(5):561-566. doi:10.1080/00016340600589487

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. doi:10.5468/ogs.2018.61.1.48

Owolabi T, Gbenga N, Oloyede V, Adebari O, Peter A. The impact of decision – delivery interval on maternal and fetal outcome: a three- year experience in a tertiary hospital. Trop J Obstet Gynaecol. 2015;32(1):46-54-54.

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 Cesarean Section deliveries: Prospective cohort study. BMC Pregnancy Childbirth. 2020;20(1):1-11. doi:10.1186/s12884-020-2828-z

Dunn CN, Zhang Q, Sia JT, Assam PN, Tagore S, Sng BL. Evaluation of timings and outcomes in category‑one Cesarean Sections: A retrospective cohort study. Indian J Anaesth. 2016;60(8):546-551. doi:10.4103/0019-5049.187782

Sutcliffe KM, Lewton E, Rosenthal MM. Communication Failures: An Insidious Contributor to Medical Mishaps. Acad Med. 2004;79(2):186-194. doi:10.1097/00001888-200402000-00019

Le Mitouard M, Gaucher L, Huissoud C, et al. Decision-delivery intervals: Impact of a colour code protocol for emergency caesareans. Eur J Obstet Gynecol Reprod Biol. 2020;246:29-34. doi:10.1016/j.ejogrb.2019.12.027

Peebles E, Subbe CP, Hughes P, Gemmell L. Timing and teamwork-An observational pilot study of patients referred to a Rapid Response Team with the aim of identifying factors amenable to re-design of a Rapid Response System. Resuscitation. 2012;83(6):782-787. doi:10.1016/j.resuscitation.2011.12.019


Article Views      : 0
PDF Downloads : 0