Decision Delivery Interval in Emergency caesarean Sections

Aims Categorisation of Emergency Caesarean sections is very important as that determines the Decision Delivery Interval (DDI) - the time between the decision and the delivery of the baby. In Category 1 the DDI is Methods A uni-centric retrospective case note audit was performed in 2011. 50 patients who had emergency section were randomly selected and pertinent data was collected using a standardised questionnaire. The standards for audit were selected from the Trust guidelines and the RCOG Good Practice Guidelines 21 Results Compliance to DDI was 73% in Category 1 sections, which improved to 80% in Category 2 sections. Although the category of section was documented in only 62%, there was 94% compliance in documentation of DDI. A busy labour ward, anaesthetic and/or paediatric delays and co morbidities were some of the reasons cited for the noncompliance. The study found that nearly 76 % women had urinary catheterisation in theatre and 80% had no prior epidural. Wrong categorisation also added to the non-compliance in a small percentage. Conclusions There is need for improvement in correct categorisation and documentation of category of Caesarean sections. Documentation of the Decision Delivery Interval and the multi-disciplinary communication too needs improvement. The audit discussion also helped to improve awareness about the continuum of risk categorisation as mentioned in the RCOG Good Practice Guidelines. Re audit is recommended after implementation of changes.