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.