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C-Section Timing Best Left to Doctor
Researchers studying the timeframe in which a Caesarean section was performed found that delaying surgery in less-threatening cases by more than 30 minutes did not boost complication risks for mother or baby.
The study, conducted by the University of Texas Southwestern Medical Center at Dallas, included more than 2,800 women.
The team found that in most cases deemed an emergency by physicians, doctors performed C-section within the 30-minute timeframe long mandated by the American College of Obstetricians and Gynecologists (ACOG). They also found that in non-emergency situations, delaying C-section by more than 30 minutes did not raise the risk of complications.
"Clearly, physician judgment plays a critical role in determining the speed with which an emergency Caesarean is performed," study author Dr. Steven Bloom, interim chairman of the center's obstetrics and gynecology department, said in a prepared statement. The women studied had undergone an emergency C-section at one of the 13 hospitals in the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development between 1999 and 2000. It was the first Caesarean for all of the women, all were single births, and all babies weighed at least 5.5 pounds.
Two-thirds of the women's procedures started within 30 minutes, and most of those began within 20 minutes. Of the babies born to these women, 92.6 percent were born without complications. In the one-third of the women whose deliveries began more than
30 minutes after the need for C-section was determined, 95.4 percent of their babies had no complications. Differences in complication rates for the mothers was also negligible between the two groups. In deliveries where the life of the mother or baby was in danger, 98 percent occurred within 30 minutes.
The team reported the findings in the July issue of Obstetrics and Gynecology. The "30-minute guideline" for emergency C-section was first established by ACOG in 1989. That guidelines states that obstetricians should have the capability to commence a Caesarean within 30 minutes. However, the researchers noted that this is a guideline, not a strict requirement.
"Having this potential should not be misconstrued to mean that it is required that all Caesareans commence within 30 minutes," investigator Dr. Kenneth Leveno, professor of obstetrics and gynecology at UT Southwestern, said in a prepared statement.
