Safe timing for an urgent Caesarean section: What is the evidence to guide policy?

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dc.contributor.author Homer, CSE
dc.contributor.author Catling-Paull, C
dc.date.accessioned 2012-10-12T03:34:17Z
dc.date.issued 2012
dc.identifier.citation Australian Health Review, 2012, 36 (3), pp. 277 - 281
dc.identifier.issn 0156-5788
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/18489
dc.description.abstract Objective. To determine, from the evidence, what is the optimum decision to delivery (DDI) intervals in emergency Caesarean sections (CS). The aim of the study was to help guide policy in maternity services and identify issues relating to DDI and safe practice in maternity care. Method. A systematic review of the literature was undertaken. Assessment of the quality of eligible papers was undertaken using the Critical Appraisal Skills Program (CASP) rating. Results. There is no strong evidence that a DDI of 30min or less is associated with improved outcomes for babies or mothers. Some evidence suggests that a DDI of greater than 30min but less than 75min confers benefit, but these findings were confounded by the indications for the emergency CS. Conclusion. Urgent CS should occur as soon as possible, but there is insufficient evidence to support a definite time frame, such as 30min. A consistency of approach and nomenclature in describing the urgency of CS is necessary, which would enable criteria for further audit regarding DDI. Staff training should be addressed to improve transfer systems for CS. Antenatal risk assessment and congruence with role delineation and service delivery capacity is important. What is known about the topic? The 30-min rule has been cited and used globally as best practice, despite the low level of supporting evidence. What does this paper add? There is no strong evidence that DDIs of less than 30min are associated with improved neonatal or maternal outcomes. A DDI of greater than 30min but less than 75min confers some benefit, but this is tempered by the urgency of the CS. What are the implications for practitioners? Urgent CS should occur as soon as possible, but there is insufficient evidence to support a definite time frame, such as 30min. A consistency of approach and nomenclature in describing the urgency of CS is necessary, which would enable criteria for further audit regarding DDI. Staff training should be addressed regarding efficient systems during transfer for CS. Careful antenatal risk assessment and congruence with role delineation and service delivery capacity is important in making recommendations for place of birth for women. © 2012 AHHA.
dc.language eng
dc.relation.hasversion Accepted manuscript version
dc.relation.isbasedon 10.1071/AH11059
dc.title Safe timing for an urgent Caesarean section: What is the evidence to guide policy?
dc.type Journal Article
dc.parent Australian Health Review
dc.journal.volume 3
dc.journal.volume 36
dc.journal.number 3 en_US
dc.publocation Canberra en_US
dc.identifier.startpage 277 en_US
dc.identifier.endpage 281 en_US
dc.cauo.name FOH.Faculty of Health en_US
dc.conference Verified OK en_US
dc.for 111006 Midwifery
dc.for 1117 Public Health and Health Services
dc.for 1110 Nursing
dc.personcode 995146
dc.personcode 995204
dc.percentage 34 en_US
dc.classification.name Nursing en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords en_US
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Health
pubs.organisational-group /University of Technology Sydney/Strength - Health Services and Practice Research


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