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Please use this identifier to cite or link to this item: https://hdl.handle.net/11055/759
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dc.contributor.authorWarren MHen_US
dc.contributor.authorKamania Jen_US
dc.contributor.authorDennis ATen_US
dc.date.accessioned2018-10-16T23:47:52Z-
dc.date.available2018-10-16T23:47:52Z-
dc.date.issued2018-02-
dc.identifier.citation33:46-52en_US
dc.identifier.urihttp://hdl.handle.net/11055/759-
dc.description.abstractBACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014. RESULTS: Within the study period 14,115 women gave birth, of which 387 women underwent an immediate birth, the majority (83%) by caesarean section. The commonest indication for immediate birth was prolonged fetal bradycardia (53%), however cord prolapse (4%) produced the most rapid decision-to-delivery interval, with a median [IQR] time of 14 [13-16] min versus 18 [14-23] min for all immediate births (P<0.01). Epidural top-up was the most common anaesthesia method. Conversion to general anaesthesia following inadequate neuraxial anaesthesia occurred in 6.2% of women. Among 103 general anaesthetics, there was one failed intubation (successful ventilation) and one dental injury. Nine women (2.3%) were admitted to the high dependency or intensive care units, and there were no maternal deaths. Babies born by caesarean section with a decision-to-delivery interval of less than 30min were more likely to have longer times to establish respiration (22.6% vs 16.7%, P<0.001). CONCLUSION: Request for immediate delivery is a common obstetric emergency. Epidural top-up has become the most common anaesthetic technique. Rapid delivery times can be achieved with an integrated emergency response system.en_US
dc.subjectPregnancyen_US
dc.subjectcesarean sectionen_US
dc.titleImmediate birth – an analysis of women and their babies undergoing time critical birth in a tertiary referral obstetric hospitalen_US
dc.typeJournal Articleen_US
dc.type.contentTexten_US
dc.identifier.journaltitleInternational Journal of Obstetric Anesthesiaen_US
dc.identifier.doihttps://doi.org/10.1016/j.ijoa.2017.06.004en_US
dc.description.affiliatesThe Royal Women's Hospital, Parkville, Australiaen_US
dc.description.affiliatesThe University of Melbourne, Parkville, Australiaen_US
dc.type.studyortrialObservational studyen_US
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:Scholarly and Clinical
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