key: cord-0819741-qkl129z7
authors: Tageldin, N.; Michelotti, F.; Elsayed, E.; Bhatia, K.; Columb, M.
title: O.5 COVID-19, category 1 caesarean sections, decision-to- delivery intervals and neonatal outcomes
date: 2021-06-09
journal: Int J Obstet Anesth
DOI: 10.1016/j.ijoa.2021.102993
sha: 5cfc914d011722136ededf2ef878b8a1d664cd68
doc_id: 819741
cord_uid: qkl129z7

nan

was no significant difference in age, parity, BMI, infant feeding method at discharge or pre-operative haemoglobin concentration between the groups. Four women were discharged within 12 h of delivery, each of whom had previous CSs. Mean age was 32 and BMI 28.7 kg/m 2. Two were breastfeeding at discharge, one had an emergency CS and blood loss ranged from 460 to 1200 mL.

Discussion: A significant proportion of women are leaving hospital before the recommended time. Those choosing to leave hospital earlier were more likely to have had a previous CS, a smaller blood loss and an elective procedure. This is in keeping with the expectation that this group would be better prepared ahead of surgery and have experienced minimal physiological disturbance. A small group of women returned home on the same day as surgery and further study is required to assess the safety of this. However, this analysis indicates that the guidance on length of stay may need to be revisited.

References [1] . Unpublished data from Information Services Division (ISD) SMR02 database, Scottish Government.. [2] Introduction: During the COVID-19 pandemic, we highlighted a significant 50% reduction in general anaesthetic (GA) rates for caesarean section (CS). 1 NICE guidance standard recommends a decision-to-delivery interval (DDI) <30 min for category (cat) 1 CS. 1 We investigated whether the increased use of regional anaesthesia (RA) for cat 1 CS during the pandemic influenced DDI and neonatal outcomes.

Methods: Electronic records precisely looking at anaesthetic technique, DDI and composite neonatal outcomes (Apgar score 5 min <7, umbilical arterial pH < 7.10 and neonatal ICU (NICU) admission) of 193 women who delivered by cat 1 CS between 1April and 30June 2019 (Pre-C19) were reviewed and compared with 147 women having a cat 1 CS during a similar period in 2020 (Post-C19).

Results: GA rates were significantly reduced during C19 (Table) . Overall DDI, number of CS with DDI <30 min and composite adverse neonatal outcomes were similar in both periods. DDI was significantly longer with spinal anaesthesia (SA). GA was significantly associated with worse composite adverse neonatal outcomes with lower Apgar scores, umbilical arterial and venous pH, and higher rates of NICU admissions.

Discussion: DDI and neonatal outcomes were not affected by reduced GA rates with COVID-19. The less favourable short-term neonatal outcomes associated with a GA in our audit are consistent with the published literature on cat 1 CS. Unless contraindicated, RA is generally preferable for cat 1 CS and our data support its increased use as reported during the COVID-19 pandemic. 2 

The effect of COVID-19 on general anaesthesia rates for caesarean section. A cross-sectional analysis of six hospitals in the northwest of England

Caesarean Section␣Clinical guideline CG 132

UK ⇑ Corresponding author. Introduction: Elevated D-dimer is associated with worse outcomes from COVID-19 in non-pregnant adults. 1 We analysed laboratory parameters of pregnant women with PCR swab positive COVID-19 to identify biomarkers associated with severe infection. Methods:After ethical approval, anonymised observational data were collected on pregnant women admitted with PCR swab positive COVID-19. Infection was classified as mild (asymptomatic screen positive/mild symptomatic) or severe

International Journal of Obstetric Anesthesia 46 (2021) 102988