Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes

Dorota Doherty, Pat Magann, S. Chauhan, A. O'Boyle, J. Busch, J. Morrison

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    25 Citations (Scopus)

    Abstract

    Aim: To determine the factors that influence caesarean operative time and operative time effects on pregnancy outcomes.Methods: Prospective observational study of women undergoing a caesarean delivery (CD). Multiple antepartum, intrapartum and neonatal outcomes were assessed for their influence on the time of the CD and the time effect of CD on pregnancy outcomes.Results: There were 386 (23%) caesarean deliveries performed <= 30 min, 1070 (65%) between 31 and 60 min, and 200 deliveries >= 60 min. Women younger than 18 years (P = 0.004) and who had caesarean for fetal labor intolerance were associated with shorter operation time (P < 0.001). Factors associated with an increased operation time were age > 35 years (P = 0.049), body mass index (BMI) >= 30 (P < 0.001), pre-existing hypertension (P = 0.001), prior low segment transverse scar (P < 0.001), uterus incision other than transverse (P < 0.001), first-year resident as primary surgeon (P < 0.001) and accompanying sterilisation procedure (P < 0.001). Operation time was significantly related to blood loss (P < 0.001), likelihood of umbilical artery cord gas pH < 7.1 (P < 0.001) and Apgar scores at five minutes < 7 (P = 0.009).Conclusions: Operative time is shortened by age < 18 and delivery for fetal labor intolerance, lengthened by age > 35, BMI > 30, prior caesarean, uterine incision, operating surgeon inexperience and accompanying sterilisation. Increased operative time was linked with an increased blood loss, low five-minute Apgar scores and umbilical arterial pH < 7.1.
    Original languageEnglish
    Pages (from-to)286-291
    JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
    Volume48
    Issue number3
    DOIs
    Publication statusPublished - 2008

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