Delayed decision-delivery time interval in emergency cesarean section, associated factors and fetal-maternal outcomes at regional referral hospitals in Dar es Salaam from April to June 2019
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Date
2019
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Publisher
Hubert Kairuki Memorial University
Abstract
Background: The recommended decision to delivery interval (DDI) in Emergency Caesarean sections 30 minutes. When the DDI is beyond 75 minutes, the prolonged duration could compromise maternal and fetal outcomes including fetal hypoxia, fresh stillbirths well as maternal postpartum hemorrhage and sepsis.
Objective: This study aimed at determining the prevalence of delay in the decision-delivery interval and factors associated with fetal-maternal outcome at referral regional hospitals in Dar es Salaam. Methodology: Descriptive cross-sectional study was conducted at Mwananyamala, Amana, and Temeke Regional Referral Hospitals in Dar es Salaam. Women delivered by Emergency Caesarian section in the three selected regional hospitals in Dar-es-salaam were recruited from April to June 2019.Data analysis was done using SPSS version 25. Continuous data and categorical data were summarized using mean/standard deviation and frequency/percentage,respectively. Multivariate analysis was done to seek association between delay and social demographic and obstetricvariables where p value at 0.05 was considered significant
Results: Emergency Caesarian was done on 306 women, amongthese 197 women had DDI of 75 minutes.The total meantime for ECS was 144.41minutes with (CI): {122.19-166.64}.The proportionalof those who delayed more than 75minutes were 64.4%.Factors associated with delayed during ECS were delayed in consent signing, lack of personnel, delay in getting blood from the blood bank, non-availabilityof operating theatre, and unavailability of instruments which was statically significance. Maternaloutcomes among the women undergone ECS were with no complications within 72hrs.while neonatal outcomes were having low APGAR score 39(12.75%) and good APGAR score were 267(87.25%)
Conclusion: Our DDI is much higher compare to other developing countries, so there is a need to improve our DDI, through availability of Emergency Obstetric operating theatre. Recommendations: There should be an Obstetrics Emergency operating room in each hospital.
Description
A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Medicine in Obstetrics and Gynecology of Hubert Kairuki Memorial University
Keywords
Emergency cesarean section, Referral hospital, Fetal-maternal
Citation
Shayo, Yohana. P., 2020. Delayed decision-delivery time interval in emergency cesarean section, associated factors and fetal-maternal outcomes at regional referral hospitals in Dar es Salaam from April to June 2019. HKMU