The decision-to-delivery interval for emergency caesarean section: is 30 minutes a realistic target?

BJOG. 2002 May;109(5):505-8. doi: 10.1111/j.1471-0528.2002.00491.x.


Objective: To evaluate whether a 30-minute decision-to-delivery interval is a realistic target for emergency caesarean section.

Design: An audit of all emergency caesarean sections over five separate periods.

Setting: A district general hospital.

Participants: Five groups of women (343 women) with an indication for emergency caesarean section.

Methods: Following an initial survey, a structured time sheet was introduced, followed by four other surveys to complete the audit cycle.

Main outcome measure: The proportion of caesarean sections where the decision-to-delivery interval was achieved within 30 minutes. The reasons for delay.

Results: In the first survey of 73 emergency caesarean sections, the time to deliver the infant exceeded 30 minutes in 47 women (64%). The main sources of delay were transferring the women to the operating theatre and starting the anaesthetic. After the introduction of a structured time sheet, there was an improvement with each survey, but the target of 30 minutes was reached in only 71% of caesarean sections in the final survey.

Conclusions: The introduction of a time sheet can improve the decision-to-delivery interval for emergency caesarean section; however, a universal standard of 100% in 30 minutes is unrealistic.

Publication types

  • Evaluation Study

MeSH terms

  • Cesarean Section / methods*
  • Decision Making*
  • Emergencies*
  • Female
  • Gestational Age
  • Humans
  • Medical Audit
  • Pregnancy
  • Pregnancy, Prolonged*
  • Time Factors