Implementation of the Four-Category Classification of Cesarean Section Urgency in Clinical Practice. A Prospective Study
| Autor: | Seila Perrone, Giusi Santangelo, Alberto Scaini, Carmine Cosentino, Francesco Maneschi, Desiree Biccirè |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
EARLY DELIVERY Pediatrics medicine.medical_specialty Time Factors decision-to-delivery interval cesarean section emergency classification acidosis Time to treatment Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Prospective Studies 030212 general & internal medicine Clinical efficacy Prospective cohort study 030219 obstetrics & reproductive medicine Cesarean Section business.industry Infant Newborn Obstetrics and Gynecology Delivery Obstetric medicine.disease Infant newborn Clinical Practice Reproductive Medicine Female business |
| Zdroj: | Gynecologic and Obstetric Investigation. 82:371-375 |
| ISSN: | 1423-002X 0378-7346 |
| DOI: | 10.1159/000449159 |
| Popis: | Purpose: This study is aimed at investigating the clinical efficacy of the 4-category classification of urgent cesarean section. Methods: Women giving birth from September 2012 to December 2014 were prospectively investigated. Urgency C-section categories were color-coded: red - maternal/fetal life threat; yellow - maternal/fetal compromise, not life-threatening; and green - early delivery necessary. Results were audited. Results: A total of 4,754 women gave birth in the period considered, 1,313 (27.6%) with C-section of which 867 were urgent. The code was red in 0.98% of women, and 91.5% of newborns were delivered ≤30'; yellow in 5.1%; and green in 11.7%. The mean decision-to-delivery interval (DDI) ± SD was 19.6 ± 9.5 min, 36.6 ± 15.3 (p < 0.01), and 80.3 ± 52.8 (p < 0.01), respectively; and mean umbilical pH was 7.24 ± 0.10, 7.29 ± 0.08 (p < 0.05), and 7.33 ± 0.04 (p < 0.01) in the red, yellow, and green groups, respectively. Two (4.2%) red and 4 (2.2%) yellow newborns were acidotic. Mean DDI ± SD decreased from 21.7 ± 9.7 min in the period September 2012 to February 2013 to 17.4 ± 9.7 min in the period February to December 2014 (p = NS). Conclusions: Four-category classification led to achieving the target time in >90% of category 1 emergency C-sections, and stratified newborns with significantly different acidosis levels. |
| Databáze: | OpenAIRE |
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