The effect of time of day on unscheduled caeserian sections on perinatal and maternal outcomes in Kenyatta National Hospital, Nairobi, Kenya

Abstract

Objectives: To compare the 72 hour post delivery maternal and neonatal outcomes among patients undergoing unscheduled Caesarean section during the night and day.

Design: Prospective cohort study.

Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya.

Subjects: Two hundred and forty Post-natal mothers who had undergone unscheduled Caesarean section.

Results: Between the months of February 26^th and April 2^nd 2015, a total of two hundred and forty patients undergoing unscheduled Caesarean sections at the KNH were recruited into the study including 120(50%) patients who had an operation performed during the night shift and 120(50%) during the day shift. Data were collected prospectively. There was no significant difference in the socio-demographic characteristics of patients according to shifts. Most procedures were conducted under regional anaesthesia with no significant differences between day and night surgeries. The leading indications for unscheduled CS during the day and night were: Non Reassuring Foetal Status (NRFS), obstructed Labour and elective CS converted to emergency CS in that order. Conversion of Elective Caesarean section to Emergency CS was significantly more common during the night compared to during daytime. Poor maternal and neonatal outcomes did not show a significant difference depending on time of surgery.

Conclusion: The study showed that there was no significant difference in pregnancy outcomes between unscheduled Caesarean section done during the day compared to those done during the night.