Case records and commentaries in Obstetrics and Gynaecology
Abstract
The decision to delivery time interval (DDI) is an important measure of the
preparedness of obstetric team in handling emergencies. Different institutions have different
levels of response time depending on their level in the health care delivery system. The two
hospitals studied are at two different levels.
evaluation of the DDI in emergency caesarean deliveries in KNH and HBDH and their
effect on the maternal and foetal outcome.
Prospective study carried out in the two hospitals over four months (January to April
2006). Results were computed and anillyscd using SPSS computer package.
A total of 638 women underwent emergency caesarean section in KNH and 615 were
analysed because they had proper recordings of the times that were of interest. In HBDH, 54
women underwent emergency caesarean section and 52 had met the criteria thus analysed.
The population at HBDH was relatively younger and of higher parity with a Mean of 24 years
versus 28 years for the population at KNH (a p-value <0.001)
The time between decision making and patient being received in theater had a range of IS-ISO
minutes for KNH and 26-180 for HBDH with a significant difference between the two hospitals
(p-value of <0.001). The time taken before delivery of the infant had a range of IS-55 minutes for
KNH while for HBDH it was 15-GO minutes. The time difference was not significant. There
appears to have been no relationship between the foetal outcome and the times taken from
decision making to delivery of the baby (p value 0.8 for KNH and 0.3 [or HBDH). The Apgar
score was found to be low for those that had a shone DDI. Those that had a shorter DDI had a life
threatening diagnosis (as Per Lucas classification). The OOI did not have an effect on the
maternal outcome in both institutions.
Homalsay District Hospital had a significantly longer DDI.
The shorter OOf was associated with a lower Apgar score.
Citation
Degree of Master of Medicine in Obstetrics and GynaecologyPublisher
University of Nairobi Department of Obstetrics and Gynaecology
Description
In Part Fulfillment for the Degree of Master of Medicine
in
Obstetrics and Gynecology
of the
University of Nairobi