• Acta Anaesthesiol Scand · Feb 2018

    Urgency of caesarean section, grading, alarm chain and intrauterine resuscitation - a survey of Scandinavian practice.

    • K Wildgaard, M Ismaiel, and F Hetmann.
    • Department of Anaesthesiology, Naestved Hospital, Naestved, Denmark.
    • Acta Anaesthesiol Scand. 2018 Feb 1; 62 (2): 167-176.

    BackgroundAbout 40,000 women have caesarean section in Scandinavia each year. Organizational factors for emergency caesarean section (CS), classification, anaesthetic practice, alarm chain, intrauterine resuscitation has all been investigated in the United Kingdom, but no information from the Scandinavian countries exists.MethodsUsing publicly available data from the National Board of Health, obstetric anaesthetic departments were identified. The heads of the departments provided e-mail contact details of two anaesthesiologists regularly practicing obstetric anaesthesia who were then surveyed.ResultsOne hundred and forty-five specialists from 82 departments in Scandinavia replied to our survey. Ninety-five percent of Danish specialists reported a three-grade classification system for urgency CS. Where classification in Denmark was enumerative classification, Norwegians equally reported enumerative and verbal descriptors, whereas Swedish specialists mostly reported verbal descriptors. Local guidelines describing decision-to-delivery interval for emergency CS was reported by 100% of Danish specialists vs. 47% from Norway and 85% from Sweden. Mean benchmark decision-to-delivery interval for emergency CS was 12.7 min. General anaesthesia for emergency CS was highly favoured in Norway (95%) and Sweden (97%), compared to Denmark (49%). Twenty specialists reported existence of local guidelines for intrauterine resuscitation.ConclusionOur survey of Scandinavian specialists indicate emergency CS practise differs from United Kingdom practices in several aspects; general anaesthesia is by the majority of Scandinavian specialists reported as the default choice for emergency CS and benchmark for decision-to-delivery interval is < 20 min. Nomenclature used for classification showed considerable variance in Norway and Sweden compared to Denmark. No joint Scandinavian guidelines exist.© 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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