Review of 197 cases of urgent cesarean section performed in 2010 using NICE classification

BACKGROUND: NICE (National Institute for Health and Clinical Excellence) of UK introduced a new classification of urgent cesarean section consisting of four categories. We classified 197 cases of urgent cesarean section performed at our institution between April 1st, 2010 and March 31, 2011, using the NICE classification. METHODS: Clinical records including obstetric record and anesthetic record were reviewed to identify possible cases as candidates of category 1 and 2, from 197 cases. Final classification was then decided at a case conference with four anesthesiologists and one obstetrician. RESULTS: Five cases were classified into category 1, and 51 cases were into category 2. There were 9 cases with umbilical pH < 7.2 among 51 cases of category 2. In these cases, quicker decision to delivery accompanies worse umbilical pH of the delivered neonate. CONCLUSIONS: The present review classifying urgent cesarean section using NICE classification revealed that most cases of urgent cesarean section were treated appropriately at our hospital. NICE guideline seems to be useful to improve anesthetic management of urgent cesarean section.