Decision To Delivery Time and Its Predictors Among Mothers Who Underwent Emergency Cesarean Delivery At Selected Hospitals of Northwest Ethiopia, 2023: Prospective Cohort Study

Figures & data

Figure 1 Schematic presentation of the sampling procedure at selected hospitals of Northwest Ethiopia, 2023.

Table 1 Socio-Demographic Characteristics of Women Undergoing Emergency Cesarean Delivery at Selected Hospitals of Northwest Ethiopia, 2023 (n=285)

Variables	Frequency (%)	Variables	Frequency (%)
Age in years		Educational status
15–20	6 (2.1%)	Cannot read and write	51 (17.9%)
20–24	65 (22.8%)	Read and write	24 (8.4%)
25–29	120 (42.1%)	Elementary	55 (19.3%)
30–35	70 (24.6%)	High school	66 (23.2)
>35	24 (8.4%)	Preparatory	23 (8.1%)
Marital status		Diploma and above	66 (23.2%)
Single	7 (2.5%)	Residence
Married	261 (91.6%)	Urban	194 (68.1%)
Divorced	12 (4.2%)	Rural	91 (31.9%)
Widowed	5 (1.8%)
Occupational status
Housewife	135 (47.4%)
Government employee	48 (16.8%)
Daily labor	13 (4.6%)
Farmer	59 (20.7%)
Merchant	29 (10.2%)
Others	1 (0.4%)

Table 2 Obstetrical Characteristics of Women Undergoing Emergency Cesarean Delivery at Selected Hospitals of Northwest Ethiopia, 2022/23 (n=285)

Variables	Frequency (%)	Variables	Frequency (%)
Number of deliveries		Referral status
Primigravid	108 (37.9%)	Yes	190 (66.7%)
Multigravida	177 (62.1%)	No	95 (33.3%)
ANC follow-up		Previous history EC/D
Yes	272 (95.4%)	Yes	65 (22.8%)
No	13 (4.6%)	No	220 (77.2%)
BPCR		OR material prepared
Yes	180 (63.2%)	Yes	247 (86.7%)
No	105 (36.8%)	No	38 (13.3%)
Informed consent		Free functional OR table	2
Agreed	258 (90.5%)	Yes	36 (82.8%)
Hesitate	27 (9.5%)	No	49 (17.2%)
Stage of labour		Type of anesthesia
Latent	154 (54%)	Regional	273 (95.8%)
Active	87 (30.5%)	General	12 (4.2)
Second	44 (15.4%)

Abbreviations: ANC, Antenatal care; BCRP, Birth preparedness complication readiness plan; OR, Operation room.

Figure 2 Decision to delivery time among women underwent emergency cesarean delivery with different indications at selected hospitals of Northwest Ethiopia, 2023.

Figure 3 Decision to delivery time among women who underwent emergency with the rank of surgeon at selected hospitals of Northwest Ethiopia, 2023.

Figure 4 The overall restricted mean decision to delivery time among women who underwent emergency cesarean delivery at selected hospitals of Northwest Ethiopia, 2023.

Figure 5 Kaplan–Meier survival curve for comparison of the mean decision to delivery time among women who underwent emergency cesarean delivery with informed consent at selected hospitals of Northwest Ethiopia, 2023.

Figure 6 Kaplan–Meier survival curve for comparison of the mean decision to delivery time among women who underwent emergency cesarean delivery with indication at selected hospitals of Northwest Ethiopia, 2023.

Figure 7 Kaplan–Meier survival curve for comparison of the mean decision to delivery time among women who underwent emergency cesarean delivery with OR material prepared at selected hospitals of Northwest Ethiopia, 2023.

Figure 8 Kaplan–Meier survival curve for comparison of the mean decision to delivery time among women who underwent emergency with free functional OR table present at selected hospitals of Northwest Ethiopia, 2023.

Figure 9 Kaplan–Meier survival curve for comparison of the mean decision to delivery time among women who underwent emergency cesarean delivery with regional anesthesia and general anesthesia at selected hospitals of northwest Ethiopia, 2023.

Table 3 Goodness-of-Fit Test Assessing Proportional Hazards Assumption

Predictors	Rho	Chi-squared	df	Prob>chi-squared
Residence	−0.05543	0.61	1	0.4339
Working time	−0.05452	0.45	1	0.5042
Consent	0.10780	1.60	1	0.2054
OR material	0.15116	2.86	1	0.0908
Free functional OR table	−0.21817	6.94	1	0.084
Types of anesthesia	−0.05565	0.55	1	0.4573
Time of transfer	−0.05946	0.20	1	0.6513
Rank of surgeon	0.08596	0.47	1	0.4943
Time of anesthesia	−0.09540	0.62	1	0.4319
Global test		14.3	9	0.5005

Table 4 Cox Regression Analysis of Predictors of Decision to Delivery Time Among Women Who Underwent Emergency Cesarean Delivery at Selected Hospitals of Northwest Ethiopia, 2023 (N=285)

Variables	Survival Status		CHR (95% CI)	AHR (95% CI)
	Delivered, N (%)	Censored, N (%)
Working time
Day	44 (21.9%)	157 (78.1%)	1	1
Night	18 (21.4%)	66 (78.3%)	0.99 (0.57–1.71)	1.6 (1.04–2.47)
Informed consent
Agreed	61 (23.6%)	197 (76.4%)	1	1
Hesitate	1(3.7%)	26 (96.3%)	0.14 (0.02–1.02)	0.17 (0.02–1.25) **
Indication for C/S
APH	8(47.1%)	9(52.9%)	1	1
Cord prolapses	12 (92.3)	1(7.7%)	1.65 (0.68–4.05)	1.36 (0.46–3.94)**
Obstructed labor	2(18.2%)	9(81.8)	0.420 (0.09–1.98)	0.43 (0.084–2.15)
GIII MSAF	6(16.2%)	31 (83.8%)	0.27 (0.93–0.77)	0.46 (0.14–1.56)
NRFHR	21 (20.4%)	82 (79.6%)	0.35 (0.16-0.80)	0.66 (0.27–1.64)
CPD	4(12.9%)	27 (87.1%)	0.19 (0.056–0.62)	0.29 (0.08–1.01)
Two C/D	2(68.9%)	27 (93.1%)	0.09 (0.02–0.46)
Others	7(44%)	37 (84.1%)	0.024 (0.09–0.66)	0.13 (0.03–0.64)
Residence
Urban	46 (23.7%)	148 (76.3%)	1	1
Rural	16 (17.6%)	75 (82.4%)	0.71 (0.40–1.25)	1.34 (0.81–2.21)
Rank of surgeon
IESO	27 (31%)	60 (69%)	0.69 (0.37–1.29)	1.49 (0.77–0.87)
MSc Clinical MW	12 (26.7%)	33 (73.3%)	0.79 (0.40–1.56)	2.88)0.87–0.91)
MSc in clinical MW students	7(8.6%)	74 (91.4%)	0.25 (0.109–0.58	0.42 (0.161–1.21)**
Senior	16 (22.2%)	56 (77.8)	1	1
OR material
Yes	60 (24.3%)	187 (75.7%)	1	1
No	2(5.3%)	36 (94.7%)	0.18 (0.04–0.73)	0.33 (0.08–1.48)
Free functional OR
Yes	59 (25%)	177 (75%)	1	1
No	3(6.1%)	46 (93.9%)	0.19 (0.06–0.62)	0.27 (0.28–0.94)**
Types of anesthesia
General	55 (20.1%) 7(5.3%	5(41.7%)	1	1
Regional	55 (20.1%)	218 (79.9%)	0.27 (0.12–0.60)	0.56 (0.25–1.28)**
Bladder flap
Yes	7(8.4.%)	76 (91.6%)	0.28 (0.12–0.62)	0.33 (0.16–0.85)*
No	55 (27.2%)	147 (72.8%)	1	1
Time transfer
≤10 min	41 (27.7%)	107 (72.3%)	1	1
>10 min	21 (15.3%)	116 (84.7%)	0.47 (0.28–0.79)	0.75 (0.42–1.34)

Notes: *Statistically significant at P value 0.25. **Significant at p value 0.05.

Abbreviations: Cesarean section, APH, Antepartum hemorrhage; GIII MSAF, Grade three meconium-stained amniotic fluid; CPD, Cephalopelvic disproportion; IESO, Integrated emergency surgeon officers; NRFHR, non reassuring fetal heart rate; MW, Midwifery.