Decision to delivery interval: a retrospective study of 1,000 emergency caesarean sections

The monitoring of the time interval from decision to operate to delivery of the fetus (DDI) for emergency caesarean sections has become an important part of an obstetric department's continuous auditing and clinical governance. The accepted standard is that the DDI for emergency caesarean sections should be 30 minutes. Previous authors have questioned whether this 30-min benchmark is a realistic target for obstetric units. This study, the largest of its kind with 1000 subjects, shows that it is not feasible for busy obstetric units to reach this target in all emergency caesarean sections. Explanations for lengthy DDI and possible improvements are proposed.