Time between skin incision and delivery during cesarean

Rossouw, Jana N. ; Hall, David ; Harvey, Justin (2013-12)

The original publication is available at http://www.ijgo.org/

Please cite as follows:

Rossouw, J. N., Hall, D. & Harvey, J. 2013. Time between skin incision and delivery during cesarean. International Journal of Gynecology and Obstetrics, 121(1):82-85, doi:10.1016/j.ijgo.2012.11.008.


Objective: To investigate factors influencing skin incision-to-delivery time (including sub-divisions thereof) and the effect of these surgical intervals on immediate neonatal outcome. Methods A prospective cohort analysis was conducted of all women undergoing cesarean delivery at Tygerberg Hospital, Cape Town, South Africa, from May 24 to November 2, 2010. Three surgical intervals were evaluated: skin incision to myometrium, myometrium to delivery, and skin incision to delivery. Neonatal outcome was assessed by the 5-minute Apgar score. Results Of 1120 cesarean deliveries recorded during the study period, 77.2% were emergency procedures, which were performed more quickly at all surgical planes (P < 0.01). Adhesions in the surgical field were present in 7.4% of all primary procedures versus 67.7% of all third procedures (P < 0.001). The skin incision-to-delivery time was significantly extended among repeat procedures (P < 0.001) and increased progressively with degree of obesity (P < 0.001). Although the 3 surgical intervals were calculated individually, none of the median values correlated with a 5-minute Apgar score below 7 for emergency deliveries. Conclusion Repeat procedures, adhesions, and obesity prolonged the time taken for cesarean delivery. Nevertheless, the effect of these factors on the 5-minute Apgar score was minimal.

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