Emergency caesarean section: influences on the decision-to-delivery interval.

Rcog/nice guidelines recommend that,for fetal compromise in labour,delivery should be accomplished ideally within 30 minutes. in this study,we investigated the factors which affect the decision-to-delivery (dd) intervals for emergency caesareans. to achieve this,prospective data were collected for all grade 1 and 2 caesareans performed on a busy labour ward over 12 months. we found that the ratio of labouring women to midwives had a significant effect on the dd intervals,which were significantly prolonged when 1 : 1 care was not provided (p < 0.001). the observed effect resulted exclusively from a prolonged transfer time to theatre. general anesthesia use shortened the dd interval for grade 1 caesareans (p < 0.001) and was more likely to be used during the day shift (p < 0.009). we conclude that midwifery staffing levels and the form of anaesthesia employed influence on dd intervals for the most urgent caesarean sections.