[Emergency Cesarean section--basic data]

Abstract

Performing a computerized multicenter-study of 66 clinics in the state of North-Rhine-Westfalia concerning the management of emergency caesarean-section (ECS), the resulting basic data were calculated as follows: In 207 cases of ECS studied, the time period needed from the decision for operation on to the beginning of surgery (DFOS) is on the average 20.4 +/- 12.3 minutes (Median 17 min., 90th Percentile 37 min.). The mere duration of surgery until delivery of the baby averaged to 4.4 +/- 2.1 min. (Median 4.0 min., 90th Percentile 7 min.). In an emergency case, on the average 24.8 +/- 12.9 minutes (Median 22 min., 90th Centile 43 min.) pass by from the decision for the operation until delivery. The median actual pH-value in umbilical artery blood of these neonates was 7.169 +/- 0.160 (N = 168). 25.0% of these neonates had pH-values below 7.1, 16.0% below 7.0 and 3.0% below 6.900. 20.1% of these babies had an Apgar-score of less than or equal to 3 after 1 min., 4 newborns received a score of 0, but recovered, whereas 4 other demised. The unpurified perinatal mortality amounted to 53.1/1000, the purified one to 48.3/1000. From these data we conclude for the time being, that 1. efforts have to be made to shorten the time factors (especially the first one (DFOS)), although there is still no evidence, that severe neonatal acidosis is significantly associated with undue long time factors in ECS; 2. further thorough analysis is need to evaluate the medical profile and the organizational background of these highest risk-deliveries.