Caesarean birth time slot allocation (1093)

Warning

Objectives

To provide guidance to clinicians requesting a theatre slot for Planned Caesarean Birth

Audience

All healthcare workers, medical and midwifery staff responsible for requesting a theatre slot for a planned Caesarean Birth.

Please report any inaccuracies or issues with this guideline using our online form

In GG&C, there is a central booking system for organising planned Caesarean births.  This is requested via the ‘referral’ tab in BadgerNet notes.

To ensure correct timing of the procedure by date, it is essential that a range of clinically acceptable dates is included in the request form.  Women who will require a specific date include

  • Women with diabetes (on Insulin or Metformin) requiring steroids prior to birth
  • Women with abnormally invasive Placenta
  • Women with coagulation disorders requiring specific blood products
  • Women where the fetus has an anomaly which requires specific timing of birth to facilitate neonatal care
  • Women who require another surgeon to be specifically present at the delivery
  • Women with complex issues who have required an MDT planning

The expectation is that there are 5 slots per theatre, per day.  Therefore, for planning of operating lists, it is essential to consider the anaesthetic and surgical time required for the procedure.  A guide for timing is included in Table 1.

This list is not exhaustive and the clinician must use their judgement to assign slots required.

Please remember to review any anaesthetic letter in Portal and Critical Alerts on BadgerNet as extra time may be required for specific anaesthetic issues.

Table 1: Specific Issues requiring additional operating time

1.5 Slots

2 Slots

BMI 45-50

BMI ≥ 50

>3 previous Caesarean Births

>4 previous Caesarean Births

Placenta Previa

Abnormally invasive placenta not requiring delivery in main theatre

Previous extensive abdominal surgery

2 items from the 1.5 slot list

Large fibroids >8cm

Laser (Fetal Medicine)

Preterm ≤ 28 weeks gestation

Maternal Cardiac conditions

Previous difficult Caesarean Birth

Patient requiring invasive monitoring

Cell Salvage required

Neonatal involvement in case for example

-MDT involvement at birth

-fetal airway abnormality

-multiple births, triplets and higher

Difficult venous access

 

Previous difficult regional anaesthesia

 

Previous difficult airway

 

Plan for General Anaesthetic/gas induction  e.g. severe needle phobia

 

Planned sterilisation/Oophorectomy

 

 

Editorial Information

Last reviewed: 28/06/2023

Next review date: 30/06/2028

Author(s): Dr Claire Higgins, Consultant O&G.

Approved By: Dr Jane Richmond, Clinical Director, Obstetrics, GG&C

Document Id: 1093