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.