Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes
Article first published online: 3 JUN 2008
Journal compilation © 2008 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. No claim to original US government works
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 48, Issue 3, pages 286–291, June 2008
How to Cite
DOHERTY, D. A., MAGANN, E. F., CHAUHAN, S. P., O’BOYLE, A. L., BUSCH, J. M. and MORRISON, J. C. (2008), Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes. Australian and New Zealand Journal of Obstetrics and Gynaecology, 48: 286–291. doi: 10.1111/j.1479-828X.2008.00862.x
- Issue published online: 3 JUN 2008
- Article first published online: 3 JUN 2008
- Received 29 January 2008; accepted 30 January 2008.
- caesarean delivery;
- operative blood loss;
- operative time;
- perinatal outcome;
- pregnancy outcome
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.