Neonatal and Maternal Short-Term Outcome after Emergency Caesarean Section in Comparison to Elective and Second Stage Caesareans: Results of A Retrospective 10-Year Survey

Purpose: The aim was to compare the neonatal and maternal short-term outcome after an emergency caesarean to the outcome after an elective and after a second stage c-section. A possible impact of the weekday and time of the day as well as the incision-to-closure time within the overall collective and the decision-to-delivery time regarding emergency caesareans on neonatal and maternal outcomes was examined. Methods: Retrospective analysis of the performed c-sections between 2004 and 2014 was carried out at a maximum-careclinic. Results: Emergency c-sections correlate significantly with low APGAR-scores, pH and a higher rate of the need of oxygen mask, intubation, reanimation and transfer to NICU. There was a higher rate of blood loss (p = 0.00001), anaemia rate (p = 0.0001) and an increased rate of fever (p = 0.01345) in emergency c-sections. Time and weekday have been influential factors as regards to the maternal and neonatal outcomes. In 319/320 emergency c-sections, a decision-to-delivery time within 20 minutes was achieved. The postnatal pHvalue was lower the longer the decision-to-delivery time was. The decision-to-delivery time was significantly shorter between 08:00 and 16:00 in comparison to other times and at the weekend. The other neonatal and maternal outcome parameters did not show significant differences. Conclusion: In the majority of cases a decision-to-delivery time of 20 minutes in a clinic with Level I care is feasible. A shorter decision-to-delivery time involves a better pH-value at birth. The maternal complication rate after emergency caesarean is not significantly higher in comparison to the one after an elective or second stage csection with regard to time and weekdays. The higher rate of blood loss, anaemia and fever in emergency csection are treatable conditions, but should bare in mind when performing an emergency c-section.