Decision-delivery interval for emergency Caesarean section and perinatal outcome in the University of Calabar Teaching Hospital Calabar, Nigeria

The internationally recommended 30 minutes decision-delivery interval for emergency caesarean section has become a cause for concern in many maternity units especially in developing countries. The aim of this study was to evaluate the feasibility of this recommendation in the University of Calabar Teaching Hospital and the consequences of any derailment. This was an analytical study that was conducted on women who had emergency caesarean section in our center over a seven-month period. None of the 150 parturients in the study population was delivered within 30 minutes of decision for emergency caesarean section. Only seven (4.7%) of the parturients were delivered within 1 hour. The mean decision-delivery interval was 3.4 hours. The perinatal mortality rate among the study population was 73 per 1000 births. Among major reasons responsible for delay in the decision-delivery interval were engagement of the theatre and non-availability of anaesthetists. Parturients with failure to progress in labour had a mean decision-delivery interval of 3.2 hours with 3.5% having moderate to severe birth asphyxia. Parturients with fetal distress had a mean decision-delivery interval of 2.8 hours with 21.9% having moderate to severe birth asphyxia. The mean decision-delivery interval of 3.4 hours was attained in parturients with obstructed labour with 50% having moderate to severe birth asphyxia. The attainment of the recommended 30 minutes decision–delivery interval for emergency caesarean section was not feasible in the University of Calabar Teaching Hospital.Key words: emergency, caesarean section, decision-delivery interval, perinatal outcom