{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T22:04:01Z","timestamp":1778537041832,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Slovenian Research Agency","award":["P3-0043"],"award-info":[{"award-number":["P3-0043"]}]},{"name":"Slovenian Research Agency","award":["P3-0124"],"award-info":[{"award-number":["P3-0124"]}]},{"name":"Slovenian Research Agency","award":["TP 20200159"],"award-info":[{"award-number":["TP 20200159"]}]},{"name":"University Clinical Centre, Ljubljana, Slovenia","award":["P3-0043"],"award-info":[{"award-number":["P3-0043"]}]},{"name":"University Clinical Centre, Ljubljana, Slovenia","award":["P3-0124"],"award-info":[{"award-number":["P3-0124"]}]},{"name":"University Clinical Centre, Ljubljana, Slovenia","award":["TP 20200159"],"award-info":[{"award-number":["TP 20200159"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. Methods: This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries. Three DDI phases were assessed for each anesthetic modality: transfer time (decision for cesarean section to admission in the operation room), anesthetic time (admission to incision), and delivery time (incision to delivery of the neonate). The surgical procedure time (incision to closure), neonatal (5 min Apgar score, umbilical artery pH\/base excess, neonatal intensive care unit (NICU) admission) and maternal (blood loss, surgical and postoperative complications) outcomes were also analyzed for each group. Results: There were 215 women (122 category 2 and 93 category 3) included. The use of epidural and general anesthesia was associated with significantly shortened DDI compared to spinal anesthesia (p &lt; 0.001). This difference was due prolonged transfer (p &lt; 0.05) and anesthetic times (p &lt; 0.001), respectively. No cases of umbilical artery pH below 7 were observed in any group. No significant differences were observed in the incidence of umbilical artery pH between 7 and 7.10 or in base excess below \u221212 nmol\/L (p = 0.416 and p = 0.865, respectively). NICU admission was higher with both general and spinal anesthesia (p = 0.021), but mainly due to a higher proportion of preterm births, both before the 32nd week (p = 0.033) and between the 32nd and 37th week of pregnancy (p &lt; 0.001). General anesthesia was associated with higher maternal blood loss (p = 0.026) and a higher rate of postoperative complications (p = 0.006). Conclusions: In category 2 and 3 cesarean deliveries, general and epidural anesthesia were associated with shorter DDI compared to spinal anesthesia with no differences in neonatal outcomes. General anesthesia was associated with a higher risk of maternal complications compared to neuraxial anesthetic techniques.<\/jats:p>","DOI":"10.3390\/jcm13247528","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T06:44:05Z","timestamp":1733899445000},"page":"7528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Anesthetic Modality on Decision-to-Delivery Interval and Maternal\u2013Neonatal Outcomes in Category 2 and 3 Cesarean Deliveries"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-3453","authenticated-orcid":false,"given":"Polona","family":"Pe\u010dlin","sequence":"first","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, \u0160lajmerjeva 3, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Pavlica","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"Dru\u0161kovi\u010d","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, \u0160lajmerjeva 3, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gorazd","family":"Kav\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-5799","authenticated-orcid":false,"given":"Ivan","family":"Verdenik","sequence":"additional","affiliation":[{"name":"Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatjana Stopar","family":"Pintari\u010d","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"},{"name":"Institute of Anatomy, Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/anae.15570","article-title":"Defining the decision-to-delivery interval at caesarean section: Narrative literature review and proposal for standardisation","volume":"77","author":"May","year":"2022","journal-title":"Anaesthesia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1136\/bmj.322.7298.1330","article-title":"Interval between decision and delivery by caesarean section-are current standards achievable? 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