The aim was to compare the neonatal and maternal short-term outcome after an emergency caesarean to the outcome after an elective and after a second stage c-section. A possible impact of the weekday and time of the day as well as the incision-to-closure time within the overall collective and the decision-to-delivery time regarding emergency caesareans on neonatal and maternal outcomes was examined.
Retrospective analysis of the performed c-sections between 2004 and 2014 was carried out at a maximum-care- clinic.
Emergency c-sections correlate significantly with low APGAR-scores, pH and a higher rate of the need of oxygen mask, intubation, reanimation and transfer to NICU.
There was a higher rate of blood loss (p = 0.00001), anaemia rate (p = 0.0001) and an increased rate of fever (p = 0.01345) in emergency c-sections. Time and weekday have been influential factors as regards to the maternal and neonatal outcomes.
In 319/320 emergency c-sections, a decision-to-delivery time within 20 minutes was achieved. The postnatal pH- value was lower the longer the decision-to-delivery time was. The decision-to-delivery time was significantly shorter between 08:00 and 16:00 in comparison to other times and at the weekend. The other neonatal and maternal outcome parameters did not show significant differences.
In the majority of cases a decision-to-delivery time of 20 minutes in a clinic with Level I care is feasible. A shorter decision-to-delivery time involves a better pH-value at birth. The maternal complication rate after emergency caesarean is not significantly higher in comparison to the one after an elective or second stage c- section with regard to time and weekdays. The higher rate of blood loss, anaemia and fever in emergency c- section are treatable conditions, but should bare in mind when performing an emergency c-section.