Determinants of Decision to Delivery Interval (DDI) in Emergency Caesarean Sections in Ladoke Akintola University of Technology Teaching Hospital Ogbomoso, Nigeria

Abstract

Background: Emergency caesarean sections are invaluable when vaginal delivery is either impossible or possess risk to the life of mother and or the foetus. Patients however still encounter delays after the decision has been made, despite recommended time frame. Objective: This is to identify the common indications for emergency caesarean section, factors responsible for delays after decision has been made and the short-term effect on the mother and neonate. Materials and methods: This was a retrospective study in which case records of patients who had emergency caesarean section were retrieved. Information about sociodemographic characteristics, booking status, parity, indication for surgery, decision time, incision time and short term feto-maternal outcomes were collected with the aid of structured proforma. Data was analyzed with Stata: Release 13 statistical software. Results: The mean age of participants was 28.9 ± 5.1 years, 51.3% were booked, primary caesarean section rate was 84.0%. The commonest indication was cephalo-pelvic disproportion (40.5%). The mean DDI was 145.3 ± 69.2 min. Patients’ factor was the leading cause of delay due to lack of funds and non-provision of surgical materials (53.5%). Leading hospital factors were non-availability of blood and blood products (32.8%) and power outage (28.0%). Five min APGAR score was normal in 92.3% of the neonates and 0.5% had severe asphyxia. Conclusion: This study shows that there are still avoidable delays in emergency caesarean section. Although there were no immediate neonatal complications, improving health care delivery so as to eliminate the identified causes would go a long way in reducing these delays.