Research Implications
To improve protocol compliance, it would be interesting to study the elements that lead to non-compliance and thus improve our decision-delivery interval. In some studies, these elements appear to be the time between the decision to perform a cesarean section and entry into the operating room, organizational deficiencies, or anesthesia difficulties (8,16).  Protocol compliance could also be improved by team simulation training which has been shown to be effective in improving the management of many pathologies in obstetrics, especially when requiring coordinated teamwork (17–20).
Strengths and limitations
The main strength of our study is the large patient sample which ensures robustness of the results on the main judgment criterion. Our population of 800 patients undergoing non-elective cesarean section is one of the largest series studying color codes in this setting. On the other hand, a higher power would have been required to demonstrate the decrease in the rate of per-partum asphyxia following the implementation of the protocol. The main weakness of our study lies in its retrospective design implying the usual biases inherent to this type of study mainly due to missing data. It is more than possible that some data, such as the color code, were announced orally at the time of the cesarean section decision but not recorded in the medical records. A prospective study would help to overcome this bias and to assess current practices as accurately as possible.