| Predictions for the decision-to-delivery interval for emergency cesarean sections in Norway. | |
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MedLine Citation:
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PMID: 16752234 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To explain the variation in decision-to-delivery intervals in emergency cesarean sections in Norway. METHODS: A seven-month prospective registration of all emergency cesareans provided by 24 maternity units. The clinician in charge filled in a predesigned form for each delivery that obtained detailed information about obstetric history, the pregnancy, indication, the date and time of delivery, decision-to-delivery interval, seniority of the surgeon, and neonatal outcome until hospital discharge. To take account of the clustered nature of our observations, data were analyzed by multilevel regression. RESULTS: 1,511 singleton emergency cesarean sections with known decision-to-delivery interval were included. The average decision-to-delivery interval for all emergency cesarean sections was 52.4 min, for acute cesarean sections 58.7 min, and for urgent emergency operations 11.8 min. Most of the decision-to-delivery interval variation was at patient level, not between departments. Several significant decision-to-delivery interval predictors were identified: 1. abruptio placentae (-54 min), umbilical cord prolapse (-37 min), and fetal stress (-35 min); 2. general anesthesia (versus regional) (-15 min), 3. cesarean sections performed during night-time (-10 min), 4. seniority of the surgeon (-6 min), and 5. cervical opening (for each cm: -6 min). CONCLUSIONS: The variance in the decision-to-delivery interval was mainly explained by the different nature of the cesarean sections. The most important predictors, which all acted to reduce decision-to-delivery interval, were the three indications abruptio placentae, cord prolapse, and fetal stress. Sections performed during night-time had significantly reduced decision-to-delivery interval. The size of the maternal units as measured by number of deliveries per year was not a significant predictor. |
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Authors:
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Toril Kolås; Dag Hofoss; Pål Oian |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 85 ISSN: 0001-6349 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2006 |
Date Detail:
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Created Date: 2006-06-05 Completed Date: 2006-06-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: Denmark |
Other Details:
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Languages: eng Pagination: 561-6 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Innlandet Hospital Trust, Lillehammer, Norway. toril.kolas@sykehuset-innlandet.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abruptio Placentae
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surgery Adult Cesarean Section* Decision Making* Emergencies Female Fetal Distress / surgery Humans Norway Pregnancy Prolapse Time Factors Umbilical Cord / pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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