Non-elective caesarean section: How long do we take to deliver?

This study measured the decision to delivery time intervals in non-elective caesarean sections and compared them to the 30-min interval suggested by international literature. It also evaluated fetal outcome. A 3-month prospective evaluation of all (n=178) non-elective caesarean sections was performed, using a structured time and data sheet, in a tertiary centre. Operations were divided into 'emergency', most pressing and 'urgent' where maternal or fetal compromise were not immediately life-threatening. The median interval for the 100 emergency cases was 48 min, and 59 min for the 78 urgent cases. Only 28 (15.7 per cent) of decision to delivery intervals were within 30 min. Twenty-two babies (12.4 per cent) had Apgar scores of below 7 at 5 min. Most decision to delivery intervals exceeded 30 min. It may be wiser to train staff to recognize and respond appropriately to emergencies than insisting on rigid decision to delivery intervals.