Adherence to the 30-minute rule in emergency caesarean deliveries due to foetal distress at Pelonomi Tertiary Hospital, Bloemfontein, South Africa

Abstract

Foetal distress is potentially life threatening, requiring an emergency caesarean delivery to forestall potential harm or death of the foetus. The American Congress of Obstetricians and Gynecologists recommended that the time from decision to emergency caesarean delivery should not exceed 30 minutes. The objective of this study was to determine whether the 30-minute rule was adhered to at Pelonomi Tertiary Hospital and to investigate the association between decision-to-incision interval and outcome of the newborn and mother. This cohort analytical study comprised 33 mothers who underwent emergency caesarean deliveries after foetal distress was diagnosed. Data were collected on time of diagnosis, start/stop time of caesarean delivery, outcome of mother and newborn and 5-minute APGAR score. Five (15.6%) of the 32 recorded decision-to-incision intervals fell within the 30-minute limit. Of the 33 neonates, two died. One mother experienced complication, but all mothers survived. The median interval in the newborns who survived was 92.5 minutes (25-850 minutes) and in the newborns who died 47.5 minutes (30-65 minutes). The study showed that the 30-minute rule in obstetrics is not adhered to, however, this did not have a direct negative effect on the outcome of the neonates or mothers.