Decision To Delivery Time and Its Predictors Among Mothers Who Underwent Emergency Cesarean Delivery At Selected Hospitals of Northwest Ethiopia, 2023: Prospective Cohort Study

Abstract

Background: The decision to delivery time is the interval between the decision and the childbirth by emergency caesarean delivery. The Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists recommend that the decision to delivery time interval is less than 30 min. Additionally, the decision to delivery time varies across institutions and countries. Objective: The aim of this study was to determine the decision to delivery time and its predictors among women who underwent emergency cesarean delivery at selected hospitals of Northwest Ethiopia, 2023. Methods: An institutional-based prospective cohort study was conducted at selected hospitals of Northwest Ethiopia, among women who underwent emergency cesarean delivery from November 1 to January 30, 2023. A total of 285 participants were enrolled, and data collected using structured and pre-tested questionnaires. A systematic sampling technique was used. Data were entered into Epi-Data version 4.6 and then exported to STATA 15 for further analysis. The log rank test was utilized to compare group differences. The time is estimated by using the Kaplan–Meier curve and Cox proportional-hazard regression analysis was carried out to determine the predictors. Results: From 285 participants, 56 (21.8%) women delivered within the recommended 30 min. The overall median survival time was undetermined and the restricted mean survival time was 48.9 min (95% CI: 47.4–50.5). The average decision to delivery time is affected among women who hesitate to accept consent (AHR: 0.17, 95% CI: 0.02–1.25), cord prolapses (AHR: 1.36, 95% CI: 0.46– 3.94), rank of surgeon (AHR: 0.42. 95% CI: 0.42–1.08), no free operation room table (AHR: 0.27, 95% CI: 0.28–0.94), regional anesthesia (AHR: 0.56, 95% CI: 0.25–1.28), and use of a bladder flap (AHR: 0.33, 95% CI: 0.16–0.85). Conclusion: Overall decision to delivery times among women who underwent emergency cesarean section at selected hospitals were longer than the recommended time.