Evidence map›Paper›PMID 32460720›Full record

ArticleBMC pregnancy and childbirth2020

Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study.

Noemi J Hughes, Imelda Namagembe, Annettee Nakimuli, Musa Sekikubo, Ashley Moffett, Charlotte J Patient, Catherine E Aiken

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Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Noemi J HughesSchool of Clinical Medicine, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, CB2 0SW, UK.
Imelda NamagembeDepartment of Obstetrics and Gynecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Annettee NakimuliDepartment of Obstetrics and Gynecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Musa SekikuboDepartment of Obstetrics and Gynecology, Makerere University and Mulago National Referral Hospital, Kampala, Uganda.
Ashley MoffettDepartment of Pathology and Centre for Trophoblast Research, University of Cambridge, Cambridge, CB2 3EG, UK.
Charlotte J PatientDepartment of Obstetrics and Gynecology, Box 223, The Rosie Hospital, Cambridge, CB2 0SW, UK.
Catherine E AikenSchool of Clinical Medicine, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, CB2 0SW, UK. cema2@cam.ac.uk.ORCID http://orcid.org/0000-0002-6510-5626

Funding

DELTAS Africa Initiative / Wellcome Trust 107743/Z/15/ZFIC NIH HHS D43 TW010132Nurture Foundation for Reproductive Research D43TW010132Wellcome Trust
6 · The paper itself

Abstract

backgroundIn many low and medium human development index countries, the rate of maternal and neonatal morbidity and mortality is high. One factor which may influence this is the decision-to-delivery interval of emergency cesarean section. We aimed to investigate the maternal risk factors, indications and decision-to-delivery interval of emergency cesarean section in a large, under-resourced obstetric setting in Uganda.

methodsRecords of 344 singleton pregnancies delivered at ≥24 weeks throughout June 2017 at Mulago National Referral Hospital were analysed using Cox proportional hazards models and multivariate logistic regression models.

resultsAn emergency cesarean section was performed every 104 min and the median decision-to-delivery interval was 5.5 h. Longer interval was associated with preeclampsia and premature rupture of membranes/oligohydramnios. Fetal distress was associated with a shorter interval (p < 0.001). There was no association between decision-to-delivery interval and adverse perinatal outcomes (p > 0.05). Mothers waited on average 6 h longer for deliveries between 00:00-08:00 compared to those between 12:00-20:00 (p < 0.01). The risk of perinatal death was higher in neonates where the decision to deliver was made between 20:00-02:00 compared to 08:00-12:00 (p < 0.01).

conclusionIn this setting, the average decision-to-delivery interval is longer than targets adopted in high development index countries. Decision-to-delivery interval varies diurnally, with decisions and deliveries made at night carrying a higher risk of adverse perinatal outcomes. This suggests a need for targeting the improvement of service provision overnight.

Indexed as

Decision MakingAdultCesarean SectionCohort StudiesEmergenciesFemaleFetal DistressHumansInfant, NewbornParturitionPerinatal DeathPregnancyPregnancy OutcomeRetrospective StudiesTime FactorsUgandaAfricaCesareanDecisionEmergencyObstetricsPerinatalUganda

Identifiers

PMID32460720
PMCPMC7251662

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.