Decision to Delivery Interval, Fetal Outcomes and Its Factors Among Emergency Caesarean Section Deliveries at South Gondar Zone Hospitals, Northwest Ethiopia: Retrospective Cross-Sectional Study, 2020

Figures & data

Table 1 Socio-Demographic and Reproductive Characteristics Study Participants, South Gondar Zone Hospitals, Northwest Ethiopia (N=510)

Characteristics	Frequency	Percent (%)
Age in years
15–24	163	32.0
25–34	287	56.3
≥35	60	11.7
Ethnicity
Amhara	500	98.0
Others*	10	2.0
Religion
Orthodox	462	90.6
Muslim	41	8.0
Others**	7	1.4
Educational status
No formal education	76	14.9
Primary	98	19.2
Secondary	86	16.9
College and above	250	49.0
Occupational status
House wife	194	38.0
Government employed	150	29.5
Private business	166	32.5
History of previous CS
No previous CS	313	61.4
One previous CS	162	31.7
Two or more previous CS	35	6.9
Gestational age in week
≤36	54	10.6
37–40	372	72.9
≥41	84	15.5

Notes: *Oromo, Tigray, Gurage; **Protestant, catholic.

Table 2 Indication of Emergency Caesarean Section, South Gondar Zone Hospitals, Northwest Ethiopia (N=510)

Indication	Frequency	Percent	DDI in Minute
			Median (IQR)
NRFHRP	123	24.1	48 (29–54)
CPD	80	15.7	55 (54–72)
Failed induction	78	15.3	76 (54–95)
Malpresentation	40	7.7	65.5 (54–83.5)
Placenta previa	37	7.3	53 (49–54)
Abruptio placenta	34	6.7	54 (53–55)
≥2 previous scars in labour	29	5.7	55 (53–78)
Prolonged labour	22	4.3	78.5 (78–85)
Impeding uterine rupture	7	1.4	54 (49–51)
Failure of trial of scar	6	1.2	53.5 (52–60)

Abbreviations: CPD, cephalopelvic disproportion; DDI, decision to delivery interval; IQR, interquartile range; NRFHRP, non-reassuring fetal heart rate pattern.

Table 3 Bivariate and Multivariate Logistic Regression Analyses on Predictors of DDI in Emergency Caesarean Section, at South Gondar Zone Hospitals, Northwest Ethiopia (N = 510)

Variables	DDI		COR	AOR	P-value
	≤ 30 Min	≤ 30 Min
	N (%)	N (%)
Availability of materials
Easily available	88 (29.2)	213 (70.8)	1	1
Took time to collect	10 (4.8)	199 (95.2)	11.8 (6.22–52.2)	10.3 (5.87–45.7)	0.000*
Time of decision
Day	7 (2.8)	245 (97.2)	1	1
Night	82 (31.8)	176 (68.2)	12.9 (7.35–36.13)	0.32 (0.15–0.67)	0.000*
Previous CS
≥two previous CS	15 (42.8)	20 (57.1)	1	1
One previous CS	68 (41.9)	94 (58.1)	1.03 (0.954–2.144)	0.73 (0.13–2.15)	0.321
No previous CS	52 (16.6)	261 (83.4)	3.76 (0.98–5.42)	1.42 (0.67–6.86)	0.976
Type of anesthesia
General	48 (34.3)	92 (65.7)	1	1
Regional	41 (11.1)	329 (88.9)	4.18 (2.59–6.74)	1.51 (0.47–4.90)	0.074
Decision of CS to anesthesia
≤15 minutes	7 (2.1)	327 (97.9)	1	1
>15 minutes	82 (46.6)	94 (53.4)	9.56 (3.41–23.28)	4.74 (1.30–17.3)	0.018*
Experience of surgeons
Obstetricians	73 (29.1)	178 (70.9)	1	1
Emergency surgeons	16 (6.2)	243 (93.8)	2.22 (3.50–11.06)	0.89 (0.07–7.54)	0.071
Experience of anesthetists
MSc holders	58 (24.2)	181 (75.8)	1	1
BSc holder	41 (17.0)	199 (83)	6.79 (3.54–18.94)	6.1 (0.99–21.2)	0.059
BSc student	9 (20.0)	22 (80)	1.13 (0.71–1.79)	1.08 (0.29–4.01)	0.900
Anesthesia to delivery of baby
≤10miutes	57 (17.2)	275 (82.8)	1	1
>10minutes	32 (18)	146 (82)	0.94 (0.58–1.52)	1.27 (0.44–3.66	0.640

Note: *P-value ≤ 0.05 considered as statistically significant.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio.

Table 4 Bivariate Logistic Regression Analyses on Neonatal Outcomes in Emergency Caesarean Section, at South Gondar Zone Hospitals, Northwest Ethiopia (N = 510)

DDI in Min	Fetal Outcomes								COR	P-value
	APGAR score at 1st minute
	<7, n (%)			≥7, n (%)
≤30 minutes	19 (21.3)			70 (78.7)					1
>30 minutes	56 (13.3)			365 (86.7)					1.76 (0.99–3.15)	0.44
	APGAR score at 5th minute
	<7, n (%)			≥7, n (%)
≤30 minutes	15 (16.9)			74 (83.1)					1
>30 minutes	28 (6.7)			393 (93.3)					2.84 (0.44–5.58)	0.23
	Bag and mask resuscitation
	Yes, n (%)			No, n (%)
≤30 minutes	6 (6.7)			83 (93.3)					1
>30 minutes	79 (18.8)			342 (81.2)					0.31 (0.13–3.74)	0.08
	Intubation
	Yes, n (%)			No, n (%)
≤30 minutes	2 (2.2)			87 (97.8)					1
>30 minutes	12 (2.9)			409 (97.1)					0.78 (0.17–3.56)	0.75
	NICU admission
	Yes, n (%)			No, n (%)
≤30 minutes	6 (6.7)			83 (93.3)					1
>30 minutes	39 (9.3)			382 (90.7)					0.70 (0.29–1.72)	0.12
	Neonatal sepsis
	Yes, n (%)			No, n (%)
≤30 minutes	3 (3.4)			86 (96.6)					1
>30 minutes	23 (5.5)			398 (94.5)					0.60 (0.17–2.05)	0.41
	Neonatal death
	Yes, n (%)			No, n (%)
≤30 minutes	3 (3.4)			86 (96.6)					1
>30 minutes	9 (2.1)			412 (97.9)					1.59 (0.42–6.02)	0.48