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Article summary:

1. This retrospective cohort study examined the incidence, indications, team response, and patient outcomes of obstetric codes requiring rapid response team activation in a high-risk tertiary care centre.

2. Common indications for Code 77 (C77) were cord prolapse and fetal bradycardia, while postpartum hemorrhage and cardiac arrest were common indications for Code Blue (CB) and Code Omega (CO).

3. The median decision-to-delivery interval was 8 minutes after C77, with emergency cesarean delivery performed for 57% of obstetric emergencies. Maternal and neonatal mortality rates were 0.68% and 7%, respectively.

Article analysis:

This article is a retrospective cohort study examining the incidence, indications, team response, and patient outcomes of obstetric codes requiring rapid response team activation in a high-risk tertiary care centre. The study is well designed and conducted in accordance with accepted research standards; however, there are some potential biases that should be noted. First, the sample size is relatively small (147 codes), which may limit the generalizability of the results to other settings or populations. Second, the data was collected retrospectively from hospital databases and health records; thus it is possible that some data may have been incomplete or inaccurate due to recall bias or other factors. Third, there is no mention of any control group or comparison group used in this study; thus it is difficult to draw conclusions about causality or make comparisons between groups. Finally, debriefing was only documented for 4% of codes; thus it is unclear how much attention was paid to understanding why certain events occurred or how they could have been prevented in the future. In conclusion, this article provides useful information on obstetric emergencies requiring rapid response team activation; however, further research with larger sample sizes and more rigorous methodology would be beneficial in order to draw more reliable conclusions about these events.