Decision-Delivery Intervals in Emergency Caesarean Sections
Summary
The decision-to-delivery interval (DDI) is the elapsed time between a clinical decision to perform an emergency caesarean section and the actual birth of the infant. International bodies often recommend a DDI of no more than 30 minutes for the most urgent (category 1) situations, yet real-world performance varies widely. Extended intervals may heighten risks of maternal haemorrhage, infection or maternal exhaustion, and increase the likelihood of neonatal acid-base disturbances or hypoxic injury. Contributing factors include anaesthetic technique and availability, theatre preparation, staffing levels, patient transfer logistics and time of day. Novel approaches—such as in situ simulation drills, dedicated rapid-response teams and refined consent pathways—have been shown to shorten DDIs, thereby aligning practice more closely with guideline targets and enhancing perinatal safety.
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Decision-Delivery Intervals in Emergency Caesarean Sections publication trend
The graph below shows the total number of articles in decision-delivery intervals in emergency caesarean sections across all publications each year (not limited to Nature Index journals).
Technical terms
Decision-to-delivery interval (DDI): The period between the clinical decision to proceed with an emergency caesarean section and the actual delivery of the baby.
Category 1 emergency caesarean section: A classification indicating immediate threat to life of the woman or foetus, necessitating the shortest possible DDI.
In situ simulation training: Team-based rehearsal of clinical scenarios conducted within the actual patient care environment to improve readiness and workflow.
Apgar score: A standardised assessment of a newborn’s health at one and five minutes after birth, evaluating heart rate, respiration, muscle tone, reflex response and skin colour.
References
- Effect of in situ simulation training for emergency caesarean section on maternal and infant outcomes. BMC Medical Education (2023).
- Evaluation of decision to delivery time interval and its effect on feto-maternal outcomes and associated factors in category-1 emergency caesarean section deliveries: prospective cohort study. BMC Pregnancy and Childbirth (2020).
- Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study. BMC Pregnancy and Childbirth (2020).
- Decision to delivery interval and associated factors for emergency cesarean section: a cross-sectional study. BMC Pregnancy and Childbirth (2021).
- Emergency Caesarean Section: Influences on the Decision‐to‐Delivery Interval. Journal of Pregnancy (2011).
- The decision to delivery interval in emergency caesarean sections: Impact of anaesthetic technique and work shift. F1000Research (2017).
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