Decision delivery interval in emergency cesarean sections and fetal and maternal outcomes: A prospective cohort study

Aim: The aim of this study is to evaluate the effect of this delay on fetal and-maternal outcomes and whether this delay causes adverse outcomes in significant proportions in a Moroccan population. Material and Methods: A prospective observational cohort study was conducted from September 2021 to April 2022 in the Gynecology and Obstetrics service of the Provincial Hospital Hassan 2, Settat Morocco with 322 parturients who presented with an indication for an emergency caesarean section. Bivariate and multivariate logistic regression analyses were carried out to identify predictors. The multicollinearity diagnostic was performed based on the inflation of variance factor Results: The average time to perform emergency caesareans was 68.95 +/- 69.607 minutes (approximate to 1 hour and 8 minutes) with extremes of 8 and 540 minutes. Over 78% of parturients had a Delivery Decision time Interval (DDI) of more than 30 minutes. Unavailability of the emergency kit (OR = 4.712, CI = 2.16-10.2), unavailability of the anesthetist team (OR = 3.239 CI = 1.532-6.847), patient's hesitation (OR = 2.883, CI = 1.471-5.651), and unavailability of the preoperative assessment (OR= 0.613, CI= 0.357-1.051) were considered as significant factors associated with prolonged DDI. Discussion: Through this study, we have concluded that the current recommendations regarding the interval between decision and delivery were not respected in Moroccan current practice. Raising the healthcare professional's awareness regarding the importance of respecting the recommendations is crucial to improve the current situation and ultimately improve fetal and maternal outcome increase