Notsectiones: Analyse der Entscheidungs-Entbindungszeit und postoperativer Wundinfektionen der Gebärenden im Krankenhaus Lainz/Wien: Eine Übersicht

Purpose: The aim of this retrospective study was to evaluate the decision-to-delivery interval (DDI) for crash cesarean sections in our department. Furthermore we tried to find out the postoperative maternal morbidity (infection of the wound), complications and the fetal outcome after surgery. Material and Methods: The reason for a crash cesarean section is acute danger for the fetus/ mother, so that surgery to deliver the child has to take place immediately. Therefore the organization has to be as effective as possible to ensure a short DDI. This can be achieved by a standardized procedure without preoperative shaving of the pubes and by minimizing disinfection methods. Results: From 2000 to 2005 fifty-seven (1.02%) crash cesarean sections were performed. The indication in 73.7% was a pathological cardiotocogram, vaginal bleeding in 14%, and cord prolapse in 7%. The average DDI was 14.4±4.2 minutes (range 8-24) while a standardized procedure was performed. None of the surviving 56 children showed a neurological deficit. Three children died postnatally. 94.7% of the patients received antibiotics perioperatively. We found no maternal wound infection. Conclusion: A standardized procedure for crash cesarean section leads to a short DDI and a good fetal outcome. The lack of abdominal disinfection but with single-shot antibiotics during surgery does not increase the rate of wound infections.