Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 7:16:433-450.
doi: 10.2147/IJWH.S451101. eCollection 2024.

Effect of Decision-to-Delivery Time of Emergency Cesarean Section on Adverse Newborn Outcomes at East Gojjam Zone Public Hospital, Ethiopia, March 2023: Multicenter Prospective Observational Study Design

Beyene Sisay Damtew  1 , Temesgen Worku Gudayu  2 , Wubedle Zelalem Temesgan  2 , Alemu Merga Hailu  3
Affiliations

Effect of Decision-to-Delivery Time of Emergency Cesarean Section on Adverse Newborn Outcomes at East Gojjam Zone Public Hospital, Ethiopia, March 2023: Multicenter Prospective Observational Study Design

Beyene Sisay Damtew et al. Int J Womens Health. .

Abstract

Background: An emergency cesarean section requires prompt delivery to reduce the risk for a pregnant woman or newborn. Studies have been conducted to investigate the relationship between decision-to-delivery time and neonatal outcomes, but the findings are contradictory. Therefore, this study aimed to assess the average of decision-to-delivery time of an emergency cesarean section and its effect on adverse neonatal outcomes at East Gojjam Zone Public Hospital.

Methods: A multicenter prospective study design would be carried out between November 2022 and January 2023. Using the consecutive method, a sample of 352 mother-newborn pairs was studied. Direct observation and face-to-face interviews were undertaken to gather the data using a semi-structured questionnaire. For both data input and analysis, Epi Data version 4.6 and Stata version 14 software were used. Both the crude and adjusted odds ratios were computed. Measure of significance was based on the adjusted odds ratio with a 95% confidence interval and a p-value of less than 0.05.

Results: Decision-to-delivery time interval within 30 minute was seen in 21.9% of emergency cesarean delivery. The study found a significant relationship between the first-minute low Apgar score and the delayed decision-to-delivery time interval (OR = 2.6, 95% CI: 1.1-6, p = 0.03). In addition, determinant factors for poor 1st-minute Apgar scores include danger signs during pregnancy (AOR: 2.9, 95% CI: 1.1-7.8, p = 0.03), women referred from another facility (AOR: 2.6, 95% CI: 1.5-4.6, p = 001), and non-reassuring fetal heart rate (AOR: 4.2, 95% CI: 1.1-17, p = 0.04). A delayed decision-to-delivery time interval is not statistically significantly associated with a low 5th-minute Apgar score or neonatal intensive care unit (NICU) admission.

Conclusion: The study found unfavorable 1st-minute Apgar score and a longer decision-to-delivery period than recommended. This duration and negative newborn outcomes may be reduced by increasing and involving comprehensive obstetric and neonatal care facilities with skilled emergency obstetric surgeons, such as clinical midwife, integrated emergency surgeon officers, and physician.

Keywords: Ethiopia; cesarean delivery; decision-to-delivery time; fetal outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schematic presentation of the sampling procedure.
Figure 2
Figure 2
Indication of emergency cesarean section at east Gojjam zone public Hospital, Ethiopia 2023.
Figure 3
Figure 3
Adverse fetal outcome emergency cesarean section at East Gojjam zone Public Hospital, Ethiopia 2023.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Saade GR, Spong CY. Introduction. Cesarean delivery. Semin Perinatol. 2012;36(5):307. doi:10.1053/j.semperi.2012.04.029 - DOI - PubMed
    1. He Y, Wu X, Zhu Q, et al. Combined laparoscopy and hysteroscopy vs. uterine curettage in the uterine artery embolization-based management of cesarean scar pregnancy: a retrospective cohort study. BMC Women’s Health. 2014;14:116. doi:10.1186/1472-6874-14-116 - DOI - PMC - PubMed
    1. Sharma S, Dhakal I. Cesarean vs vaginal delivery: an institutional experience. J Nepal Med Assocc. 2018;56(209):535–539. doi:10.31729/jnma.3467 - DOI - PMC - PubMed
    1. National Institute forH, Care E Copyright ©. NICE Process and Methods Guides. Developing NICE Guidelines: The Manual. London: National Institute for Health and Clinical Excellence, unless otherwise stated; 2015.
    1. Rashid N, Nalliah S. Understanding the decision-delivery interval in cesarean births. IeJSME. 2007;1(2):61–68. doi:10.56026/imu.1.2.61 - DOI