Onyi Onuoha1, Rohit Ramaswamy2, Emmanuel K Srofenyoh3, Sung M Kim4, Medge D Owen5. 1. Department of Anesthesiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 2. Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. 3. Department of Obstetrics and Gynecology, Ridge Regional Hospital, Accra, Ghana. 4. Wake Forest School of Medicine, Winston-Salem, NC, USA. 5. Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: mowen@wakehealth.edu.
Abstract
OBJECTIVE: To evaluate the effects of having a dedicated obstetric operating room (OR) on the decision-to-delivery interval (DDI) in a large referral hospital in Ghana. METHODS: An observational study was undertaken of all patients undergoing cesarean delivery at Ridge Regional Hospital, Accra, before (pre-OR; August-September 2011) and after (post-OR; August-September 2012) introduction of an obstetric OR. The primary outcome was the DDI. RESULTS: In total, 581 cesareans were performed in the pre-OR period and 574 in the post-OR period. Overall, the median DDI decreased from 259 min (interquartile range [IQR] 161-432) in the pre-OR period to 195 min (IQR 138-319) in the post-OR period (P<0.001). DDI was lower in the post-OR period than in the pre-OR period for both emergency (175 min [IQR 126-241] vs 220 min [IQR 146-315]; P<0.001) and elective (1828 min [IQR 1432-2985] vs 4291 min [IQR 2992-5862]; P<0.001) cesarean deliveries. Only one emergency cesarean-in the post-OR period-was conducted within the recommended 30-minute timeframe. CONCLUSION: An obstetric OR lowered the DDI for cesarean delivery; however, a realistic timeframe for emergency cesareans in low-income countries remains to be determined.
OBJECTIVE: To evaluate the effects of having a dedicated obstetric operating room (OR) on the decision-to-delivery interval (DDI) in a large referral hospital in Ghana. METHODS: An observational study was undertaken of all patients undergoing cesarean delivery at Ridge Regional Hospital, Accra, before (pre-OR; August-September 2011) and after (post-OR; August-September 2012) introduction of an obstetric OR. The primary outcome was the DDI. RESULTS: In total, 581 cesareans were performed in the pre-OR period and 574 in the post-OR period. Overall, the median DDI decreased from 259 min (interquartile range [IQR] 161-432) in the pre-OR period to 195 min (IQR 138-319) in the post-OR period (P<0.001). DDI was lower in the post-OR period than in the pre-OR period for both emergency (175 min [IQR 126-241] vs 220 min [IQR 146-315]; P<0.001) and elective (1828 min [IQR 1432-2985] vs 4291 min [IQR 2992-5862]; P<0.001) cesarean deliveries. Only one emergency cesarean-in the post-OR period-was conducted within the recommended 30-minute timeframe. CONCLUSION: An obstetric OR lowered the DDI for cesarean delivery; however, a realistic timeframe for emergency cesareans in low-income countries remains to be determined.
Authors: Luca Ragazzoni; Francesco Barone-Adesi; Marta Caviglia; Giovanni Putoto; Andrea Conti; Francesca Tognon; Amara Jambai; Matthew Jusu Vandy; Daniel Youkee; Riccardo Buson; Sara Pini; Paolo Rosi; Ives Hubloue; Francesco Della Corte Journal: BMJ Glob Health Date: 2021-11