RESUMO
Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval [DDI] of
Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of <7 at five minutes, admission to the Special Care Baby Unit [SCBU] or a stillbirth
Results: In the initial cycle, a DDI of 60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores [P <0.001 each]. Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre
Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes