Table 1 Summary of data extracted from contemporaneous medical notes
From: Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study
Data | Details |
|---|---|
Maternal age | Self-reported by mother or referring clinician. |
Gestational age | Calculated from the date of last menstrual period stated by mother or symphysial-fundal height. Routine first trimester US is not available in this context. |
Previous cesarean section | Evidenced by an existing abdominal scar, with maternal report. |
Comorbidities (composite factor) | One or more of HIV, active malaria and sickle-cell crisis as stated by mother or diagnosed by attending clinician. |
Pre-eclampsia | Diagnosed according to modified ACOG guidelines [16] – blood testing is not routinely available for investigating suspected pre-eclampsia, therefore the criteria based on biochemical results were not applied. |
Antepartum haemorrhage | Any fresh vaginal blood loss reported by the mother prior to delivery |
Premature rupture of membranes / oligohydramnios | Premature rupture of membranes based on maternal history, oligohydramnios was diagnosed by clinicians on the basis of clinical examination +/− ultrasound scan |
Uterine rupture | Based on clinical suspicion at the time of decision-making |
Obstructed labour | Diagnosed by the decision-making clinician based on examination (e.g. excessive fetal caput, haematuria) or history (e.g. length of time in labor) |
Fetal distress | Diagnosed by the decision-making clinician based on clinical suspicion e.g. meconium stained liquor or decelerations on intermittent auscultation. Continuous fetal monitoring, and fetal blood sampling were not available |
Malpresentation | Diagnosed by the delivering clinician |
Cord prolapse | Diagnosed by the delivering clinician |
Decision | Date and time at which the decision to deliver by emergency cesarean section was recorded in the contemporaneous medical notes. |
Delivery | Date and time at which the neonate was delivered according to the operation note |
Decision-to-delivery interval | Calculated to the nearest minute |
Adverse maternal outcome (composite) | One or more: confirmed uterine rupture at delivery, severe postpartum haemorrhage (≥1 L blood), emergency hysterectomy, admission to the High-Dependency Unit or obstetric palsy |
Neonatal APGAR scores | Recorded at 1 and 5 min |
Stillbirth | Viable baby born with no signs of life that was believed to have been alive at admission to hospital |
Neonatal death | Live birth at viable gestational age, followed by death prior to hospital discharge |
Perinatal death (composite) | All stillbirths and neonatal deaths (defined as above) |
Adverse neonatal outcome (composite) | One or more of birth asphyxia, resuscitation, birth trauma and respiratory distress |
Gravidity | Self-reported number of previous pregnancies |
Parity | Self-reported number of previous deliveries ≥24 weeks |
Birth weight | Recorded to the nearest 100 g |
Neonatal sex | As recorded in contemporaneous medical record |