• Int J Gynaecol Obstet · Sep 2015

    The effects of resource improvement on decision-to-delivery times for cesarean deliveries in a Ghanaian regional hospital.

    • Onyi Onuoha, Rohit Ramaswamy, Emmanuel K Srofenyoh, Sung M Kim, and Medge D Owen.
    • Department of Anesthesiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
    • Int J Gynaecol Obstet. 2015 Sep 1; 130 (3): 274-8.

    ObjectiveTo evaluate the effects of having a dedicated obstetric operating room (OR) on the decision-to-delivery interval (DDI) in a large referral hospital in Ghana.MethodsAn observational study was undertaken of all patients undergoing cesarean delivery at Ridge Regional Hospital, Accra, before (pre-OR; August-September 2011) and after (post-OR; August-September 2012) introduction of an obstetric OR. The primary outcome was the DDI.ResultsIn total, 581 cesareans were performed in the pre-OR period and 574 in the post-OR period. Overall, the median DDI decreased from 259 min (interquartile range [IQR] 161-432) in the pre-OR period to 195 min (IQR 138-319) in the post-OR period (P<0.001). DDI was lower in the post-OR period than in the pre-OR period for both emergency (175 min [IQR 126-241] vs 220 min [IQR 146-315]; P<0.001) and elective (1828 min [IQR 1432-2985] vs 4291 min [IQR 2992-5862]; P<0.001) cesarean deliveries. Only one emergency cesarean-in the post-OR period-was conducted within the recommended 30-minute timeframe.ConclusionAn obstetric OR lowered the DDI for cesarean delivery; however, a realistic timeframe for emergency cesareans in low-income countries remains to be determined.Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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