The New Indian Journal of OBGYN. 10(2):366-371

Adherence to timeline for decision to delivery interval in accordance with NICE guidelines and its impact on neonatal outcomes in a rural tertiary health care centre of Central India

Shuchi Jain, Purnima Bhandari, Ketki Thool, Manish Jain, Poonam V Shivkumar

ABSTRACT

Objectives: Aims of this study were to determine the caesarean section rate in our rural tertiary health care centre, to perform an audit of decision to delivery interval for emergency caesarean sections, to compare our timings with the recommended DDI (decision to delivery interval), to evaluate the factors contributing to delay in DDI and to analyse the impact of DDI on maternal and fetal outcomes. Methods: This retrospective observational study was conducted in the Department of Obstetrics and Gynaecology at Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra over a period of 18 months from January 2015 to June 2016. Data was retrieved from the hospital files during working hours within 24 hours of the caesarean section. Results: Caesarean section rate (CSR) during study period was 36.9%. Main causes of delay were the delay in obtaining consent in 312 (20%), arranging blood in 489 (31.3%) and anaesthesia procedural delay in 659 (42.2%) patients. Among category 1 CS, APGAR score at 1 minute and 5 minutes was not significantly different between CS with DDI≤30 minutes and those with DDI>30 minutes (p - value >0.05). Also, among category 2 CS, APGAR score at 1 minutes and 5 minutes was not significantly different between CS with DDI ≤75 minutes and those with DDI >75minutes (p- value >0.05). Conclusion: DDI should be considered as one of the important contributing factors but not the sole factor in determining the maternal and neonatal outcomes in emergency caesarean sections.