Caesarean Section Rate and Frequencies of Indications Using Robson–Ten Classifications

OBJECTIVES: To determine the caesarean section rate (CSR) and frequency of different indications of caesarean section (CS) in a tertiary care hospital. METHODOLOGY: A retrospective study done in the Department of Obstetrics and Gynecology Hayatabad Medical Complex Hospital Peshawar, a tertiary care hospital, from a period of 1st January 2019 till 31st December 2019. The required data was collected from the patient’s hospital records (clinical charts) with the consent of the hospital ethical committee. RESULTS: The total number of deliveries over the study period was 5611. Out of these 1258 patients were delivered through caesarean section (CS), giving a CSR of 22%. The main contributing groups in our study were Robson Groups R5 (multiparous with prior CS, singleton, cephalic and >37 weeks), R1 (nulliparous, cephalic, singleton >37 weeks in spontaneous labor or CS) and R6 (all nulliparous breeches) with percentages of 21.1%, 17.5% and 12.9% respectively. CONCLUSION: Our study showed Robson Groups 5, 2 and 6 as the major contributors, focusing on these groups could have an impact on decreasing the cesarean section rate in future. Limiting the primary cesarean section rate can affect the overall cesarean section rate (CSR).

[1]  I. Sohail,et al.  Auditing the cesarean section rate by Robson’s ten group classification system at Tertiary Care Hospital. , 2020 .

[2]  Barbara L. Welther,et al.  The impact , 1995 .

[3]  D. Yusef,et al.  The impact of cesarean section on neonatal outcomes at a university-based tertiary hospital in Jordan , 2019, BMC Pregnancy and Childbirth.

[4]  W. Cheng,et al.  The risk of abnormal placentation and hemorrhage in subsequent pregnancy following primary elective cesarean delivery , 2020, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[5]  A. Kant,et al.  Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate , 2018, International Journal of Reproduction Contraception Obstetrics and Gynecology.

[6]  B. Okusanya,et al.  Effect of training on the knowledge and use of the partograph for low risk pregnancies among health workers in a tertiary hospital in Lagos State, Nigeria , 2018 .

[7]  F. Barros,et al.  Global epidemiology of use of and disparities in caesarean sections , 2018, The Lancet.

[8]  S. Fatima,et al.  CAESARIAN SECTIONS: FREQUENCY AND INDICATIONS AT PERIPHERAL TERTIARY CARE HOSPITAL , 2018 .

[9]  Rubina Izhar,et al.  Adoption of Robson's Ten Group Classification System (RTGCS) to Analyse Caesarean Section Rates at a Tertiary Care Centre in Pakistan , 2018, ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE.

[10]  B. Horta,et al.  Maternal complications and cesarean section without indication: systematic review and meta-analysis , 2017, Revista de saude publica.

[11]  Y. Khang,et al.  Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013 , 2017, PloS one.

[12]  Sadia Ali,et al.  EFFECTIVENESS OF NIFEDIPINE IN EXTERNAL CEPHALIC VERSION , 2017 .

[13]  A. Samba,et al.  A Review of Caesarean Sections Using the Ten-group Classification System (Robson Classification) in the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana , 2016 .

[14]  Jun Zhang,et al.  The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014 , 2016, PloS one.

[15]  R. Mikolajczyk,et al.  WHO Statement on Caesarean Section Rates , 2015, BJOG : an international journal of obstetrics and gynaecology.

[16]  N. Maitra,et al.  Examining Cesarean Delivery Rates Using the Robson’s Ten-group Classification , 2016, The Journal of Obstetrics and Gynecology of India.

[17]  M. Robson,et al.  Quality assurance: The 10‐Group Classification System (Robson classification), induction of labor, and cesarean delivery , 2015, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[18]  J. Ford,et al.  Variation in hospital caesarean section rates for women with at least one previous caesarean section: a population based cohort study , 2015, BMC Pregnancy and Childbirth.

[19]  Y. Cakmak,et al.  Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia , 2015, International journal of women's health.

[20]  M. Naeem,et al.  RATE AND INDICATIONS OF ELECTIVE AND EMERGENCY CAESAREAN SECTION; A STUDY IN A TERTIARY CARE HOSPITAL OF PESHAWAR. , 2015, Journal of Ayub Medical College, Abbottabad : JAMC.

[21]  M. Adhi,et al.  Rates of caesarian section and trials and success of vaginal birth after caesarean sections in secondary care hospital. , 2015, JPMA. The Journal of the Pakistan Medical Association.

[22]  M. Torloni,et al.  A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It , 2014, PloS one.

[23]  C. East,et al.  Fetal pulse oximetry for fetal assessment in labour. , 2004, The Cochrane database of systematic reviews.