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Slight Delay in Emergency C-Section Seen As Safe

Study finds that the decision-to-incision interval has no effect on maternal and infant outcomes

TUESDAY, July 11 (HealthDay News) -- Maternal and infant outcomes are not adversely affected when emergency Caesarean sections are performed more than 30 minutes after the decision to operate, according to a study in the July issue of Obstetrics & Gynecology.

Steven L. Bloom, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues studied data on 11,481 primary Caesarean deliveries, 2,808 of which were performed for emergency indications.

The researchers found that 1,814 (65 percent) of the emergency deliveries commenced within the 30-minute dictum established by the American College of Obstetricians and Gynecologists. They found that maternal complication rates were not linked to the decision-to-incision interval, that newborn compromise was significantly greater when surgery started within 30 minutes of the decision to operate, and that 95 percent of infants delivered after more than 30 minutes experienced no measures of newborn compromise.

"Although this latter finding may seem reassuring at first glance, it might be argued that a 5 percent incidence of compromised infants is not acceptable considering that these infants were born at or near term," the authors state. "However, this position presumes that these 5 percent were preventable by shorter response times, which seems problematic given that similar outcomes occurred in births before the 30-minute time post. Such vagaries serve to underscore some of the clinical realities of the 30-minute dictum."

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