Decision to delivery interval in emergency caesarean Section and its effect on fetus outcomes, jimma medical Center, southwest ethiopia

Abstract

Background: Emergency cesarean section is a vital part of global maternal health care and the modern evidence point out that the goal of the World Health Organization for secure access and quality of care for pregnant women and newborns in Africa has not yet been achieve. This study was aimed to determine the average DDI for an emergency caesarean section in pregnant women and its effect on fetal outcomes, at JMC- Jimma, Southwest Ethiopia. Method: A prospective observational cohort study was conducted from May first to October 20 th 2021 at Jimma Medical Center Obs & Gyn department, Jimma University. A total of 360 clients who were undergone emergency caesarean section were included in this study. Statistical analysis was performed using electronic Kobo collect structured questionnaire then transferred in to SPSS version 26. Bivariate and multivariate logistic regression and crosstabs with a 95% confidence interval was used to determine the association of decision to delivery time interval with predictor variables and fetal outcomes. Results: Only 2.8% of women had a decision to delivery time interval below 30 min. The mean decision to the delivery time for emergency caesarean section in our study was 40± SD 5.7 min. This study showed that the time from decision to transfer patient to OT [AOR=3.85,95%CI=2.7-21.3], time taken to give anesthesia, Skin incision to delivery [AOR=17.3,95%CI =3.7-80.7], cervical dilatation [AOR=12,95%CI=1.4-105] were statistically significant predictors for DDI. In our study we found that the predictors for NICU admission were; type of newborn resuscitation, duration of labor, duration rupture of membranes and skin incision to delivery were statistically had significant influence on fetal admission in to NICU P<0.05. DDI influence on fetal outcomes in emergency caesarean section was not significant with P value; >0.05. Conclusion: Delivery was not achieved within the recommended time interval in the majority of emergency caesarean sections. DDI for emergency caesarean section has not revealed a statistically significant influence on fetal outcomes