Decision-to-delivery intervals and total duration of surgery for Caesarean sections in a tertiary general hospital

Singapore Med J. 2017 Jun;58(6):332-337. doi: 10.11622/smedj.2016098. Epub 2016 Jun 1.


Introduction: This study aimed to determine the decision-to-delivery intervals (DDIs), total duration of surgery and factors influencing these for Caesarean sections (CSs).

Methods: A retrospective study was conducted of all CSs performed from August 2013 to June 2014 at a single tertiary general hospital. Data collected included maternal demographics, indications for CS, category of urgency, DDI, total duration of surgery, grade of first surgeon and number of previous CSs.

Results: In total, 488 CSs (Category 1: n = 28; Category 2: n = 137; Category 3: n = 184; Category 4: n = 139) were studied. Overall mean duration of surgery was 41.7 minutes. Mean DDI was 23.9 minutes and 64.5 minutes for Category 1 and Category 2 CSs, respectively. For Category 1 CSs, deliveries during office hours had a significantly shorter DDI than deliveries out of office hours (p < 0.05). For Category 2 CSs, deliveries during office hours had a significantly longer DDI (p < 0.05). Total duration of surgery for senior surgeons was significantly shorter than for trainee surgeons (p < 0.05). Women with no previous CSs had a significantly shorter duration of surgery than those who had one or more (p < 0.05).

Conclusion: The majority of the deliveries were within the recommended DDI corresponding to the degree of urgency of CS. The influence of time of day on DDI might be due to challenges of time taken to transfer patients to operating theatres. Total duration of surgery was influenced by surgical experience, history of previous CS and individual surgical styles and preferences.

Keywords: Caesarean section; decision-to-delivery interval; fetal distress; total duration of surgery.

MeSH terms

  • Cesarean Section / statistics & numerical data*
  • Cesarean Section, Repeat / statistics & numerical data
  • Female
  • Fetal Distress / epidemiology
  • Fetal Distress / surgery
  • Humans
  • Operative Time
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Tertiary Care Centers
  • Time Factors