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Time from consent to cesarean delivery during labor
Kirsten Salmeen1, Cynthia Brincat
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
American Journal of Obstetrics and Gynecology
|May 11, 2013
Summary
Informed consent for cesarean delivery during labor is often brief, especially for fetal heart rate indications. This short consent time may compromise the quality of patient understanding and discussion.
Area of Science:
- Obstetrics and Gynecology
- Informed Consent Research
- Patient Safety
Background:
- Informed consent (IC) for cesarean delivery (CD) during labor presents unique time constraints.
- The quality of IC can be affected by the urgency of the clinical situation.
Purpose of the Study:
- To describe the time from consent to incision (consent time) for cesarean delivery obtained during labor.
- To identify risk factors associated with particularly short consent times.
Main Methods:
- Retrospective chart review of 90 cesarean delivery cases during labor.
- Analysis included medians, interquartile ranges, multivariable regressions, and Kaplan-Meier survival analysis.
- Comparison of consent times for fetal heart rate indications versus other indications.
Main Results:
- Median consent time was 48 minutes (IQR, 25-72 minutes).
- 28.9% of patients had less than 30 minutes from consent to incision.
- Cesarean delivery for fetal heart rate indications was associated with 4.7 times higher odds of delivery within 30 minutes of consent.
Conclusions:
- Informed consent for cesarean delivery during labor is frequently brief.
- Short consent times, particularly for fetal heart rate indications, may limit the quality of patient understanding.
- Further research is needed on optimal methods for obtaining informed consent for cesarean delivery during labor.
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