The Relationship of Response Time of Emergency C-Sections with Maternal and Perinatal Outcomes in the Emergency Installation of RSUP Dr Kariadi Semarang: Observations in the COVID-19 Era

Abstract

BACKGROUND: Emergency caesarean section is a surgical procedure performed when there is an immediate threat to the life of the fetus and/or mother. The interval in minutes between the decision for a cesarean section by the obstetrician until the incision is carried out is called the response time. Long response times in emergency caesarean section cases have been reported to be associated with worsening maternal and perinatal outcomes. Research shows that the COVID-19 pandemic also influences the incidence of emergency caesarean section in hospitals.

AIMS:  Analyzing the relationship between the response time for emergency caesarean section and the outcomes of maternal and perinatal in the emergency department of RSUP Dr. Kariadi Semarang in the era of COVID-19

METHOD: A retrospective observational analysis, cross-sectional time series study of three waves of COVID-19 involving 205 emergency cesarean section patients divided into 56 patients in wave 1, 85 patients in wave 2 and 64 patients in wave 3. The independent variable of the study was response time for emergency caesarean section. The dependent variables of the study were maternal outcomes (blood transfusion, puerperal fever, surgical site infection, hysterectomy, postpartum hemorrhage, and maternal death) and perinatal outcomes (APGAR score, need for resuscitation, prematurity and infant death). The confounding variables are the hour of the incident (hour of day), the day of the incident (day of week). The Chi-square test and Fischer Exact test were used to analyze with significant results if p<0.05

RESULT:  There is no relationship between the response time for emergency caesarean section procedures in the emergency department during the three waves of the COVID-19 pandemic at RSUP Dr. Kariadi Semarang with the need for blood transfusion (p=1,000), maternal childbed fever (p=1,000), surgical site infection (p=1,000), hysterectomy (p=1,000), postpartum hemorrhage (p=1,000), maternal death (p =1,000), APGAR score (p=1,000), need for resuscitation (p=1,000), prematurity (p=0.487) and infant death (p=1,000).

CONCLUSION: There is no relationship between the response time for emergency caesarean section procedures in the emergency department during the three waves of the COVID-19 pandemic at RSUP Dr. Kariadi Semarang with maternal outcomes and perinatal outcomes.

Keywords: COVID-19, emergency caesarean section, response time, maternal outcomes, perinatal outcomes