Secondary objectives
Among the 1097 mid-cavity VAD attempts, 600 (54.69 %) were performed in
the operating theatre, of which 445 were successful VADs and 155 were
failed VADs. 12 failed VADs were performed in a standard delivery room.
Equipment preparation made for a C-section was anticipated for 192
attempts (17.50 %), of which 104 were successful VADs and 88 were
failed VADs. 106 failed VADs (54.64 %) did not benefit from the
anticipated preparation of C-section equipment. Among the 194 failed
mid-cavity VADs, 42 (21.65 %) benefited from an anticipated extension
of epidural analgesia.
Advanced preparation of C-section equipment (p < 0.001) and
anticipated extension of epidural analgesia (p < 0.001) were
significantly associated with a decrease in the delay between VAD
failure and birth by C-section (Table 3). Delivery in the operating
theatre (p = 0.015) and anticipated extension of epidural analgesia (p =
0.032) were significantly associated with a decrease in the need for
general anaesthesia for the mother (Table 3).
Among the successful VADs, the following three neonatal outcomes were
significantly worse when women were transferred to an operating theatre
than when women stayed in the standard delivery room: the five-minute
Apgar score (9.562 versus 9.705, respectively; p = 0.025); immediate
neonatal resuscitation rate (29.44 % versus 20.09 %, respectively; p =
0.0011); and rate of neonatal transfer to the neonatal unit or neonatal
intensive care unit (6.74 % versus 3.49 %, respectively; p= 0.027).
There was no significant difference between these two groups concerning
the other maternal and neonatal outcomes.