Introduction
Cesarean section is one of the most frequent surgical procedures
performed in the world (1) and represents 20.2% of all births in France
in 2016 (2). Emergency cesarean sections may occur in different
clinical situations with varying degrees of emergency (3). Many studies
have tried to find the acceptable time frame for an emergency cesarean
section, but there is no international consensus to date (4). Some
learned societies advocate an acceptable decision-delivery interval,
such as in the United Kingdom or Germany (5,6).
In France, Dupuis et al developed
a tool to classify emergency cesarean sections in 2000 (7). This tool is
based on medical indications identified by Lucas et al. and comprises
three color coded categories (3,8):
- Green: Non-urgent cesarean section with a
decision-delivery interval ≤1 hour.
- Orange: Urgent cesarean section with a
decision-delivery interval ≤30
minutes.
- Red: Cesarean section to be performed in extreme
emergency with a decision-delivery ≤15 minutes.
The aim of this study was to
evaluate compliance with the color coded protocol in terms of indication
and decision-delivery intervals since its implementation in our
maternity ward in 2014, and its impact on maternal and fetal outcomes.