Changing trends over 5 years in indications of caesarean section as per Robson’s group classification in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231914Keywords:
Caesarean section, Multipara, Nullipara, Previous LSCS, Robson groupAbstract
Background: Caesarean section is the most common obstetric operation that saves lives of countless mother and babies. However, its inappropriate usage may also be a reason for circumstantial increase in maternal and perinatal morbidities and mortalities. Aim of this study was to examine Changing trends in indications of Cesarean delivery rates based on Robson’s groups classification in the Department of Obstetrics and Gynecology, MLN Medical College, Prayagraj over 5-year period.
Methods: Our study was a retrospective observational study over 5 years (January 1, 2016 to December 31, 2020) period in Department of Obstetrics and Gynecology, SRN Hospital, MLN Medical College, Prayagraj. All women who came to SRNH labor room for delivery during the duration of study. All vaginal deliveries including operative vaginal deliveries and all C section done after 28weeks of pregnancy. Analysis of C section indication according to Robson Classification.
Results: There were 10,332 vaginal deliveries and 5306 cesarean deliveries during this 5 year of study period. The 5-year overall CSR of our tertiary care hospital was 33.9 %, which varied from 38 % in 2016 and has steadily fallen to 26.8 % in 2019-2020. Robson’s group one had the maximum number of subjects (n = 3800), out of which 37% (n =1441) had cesarean section followed by group 3, of which, 15 % (n = 546) underwent cesarean section.
Conclusions: The ten-group classification relies on well-defined parameters, and it may well be easily applied to the present dataset of 15638 deliveries. It helped to spot the main groups of subjects who contribute most to the overall CS rate. It also aided to identify subgroups which required closer monitoring for in-depth investigation of the indications for cesarean section. It is important to target the first four groups of TGCS which constitute about 75 % of all deliveries.
References
Yadav RG, Maitra N. Examining cesarean delivery rates using the Robson’s ten-group classification. J Obstet Gynecol of India. 2016;66(Supp 1):1-6.
Hasani SA, Fathi M, Daadpey M, Zare MA, Tavakoli N, Abbasi S. Accuracy of bedside emergency physician performed ultrasound in diagnosing different causes of acute abdominal pain: a prospective study. Clin Imag. 2015;39(3):476-9.
Preetkamal, Kaur H, Nagpal M. Is current rising trend Of cesarean sections justified? Int J Reprod Contracept Obstet Gynecol. 2017;6(3):872-6.
WHO. Robson Classification: Implementation Manual, 2017. Available at: https://www.who.int/ publications/i/item/9789241513197. Accessed on 22 March 2023.
Abubeker FA, Gashawbeza B, Gebre TM, Wondafrash M, Teklu AM, Degu D, et al. Analysis of cesarean section rates using Robson ten group classification system in a tertiary teaching hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC Preg Childb. 2020;20:1-7.
Abdo AA, Hinderaker SG, Tekle AG, Lindtjørn B. Caesarean section rates analysed using Robson’s 10-Group Classification System: a cross-sectional study at a tertiary hospital in Ethiopia. BMJ open. 2020;10(10):e039098.
Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contrac Obstet Gynecol. 2018;7(11):4674-7.
Dhodapkar SB, Bhairavi S, Daniel M, Chauhan NS, Chauhan RC. Analysis of Caesarean sections according to Robson’s ten group Classification system at a tertiary care teaching hospital In South India. Int J Reprod Contracept Obstet Gynecol. 2015;4(3):745-9.
Varija T, Kumar CMV, Tarihalli C. Analysis of caesarean Section rate in tertiary care hospital according to Robson`s 10 groups classification. Int J Reprod Contrac Obstet Gynecol. 2018;7(4):1380-4.
Mittal P, Pandey D, Suri J, Bharti R. Trend prediction for cesarean deliveries based on Robson classification system at a tertiary referral unit of North India. J Obstet Gynecol India. 2020;70:111-8.
Wanjari SA. Rising caesarean section rate: a matter of Concern? Int J Reprod Cont Obstet Gynecol. 2014;3(3):728-31.
Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, et al. Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Glob Heal. 2015;3(5):e260-70.
Community Medicine for Academics and Lay Learners. WHO (10 April 2015): Perform Caesarean sections only when medically necessary; Use Robson Classification. Available at: https://communitymedicine4all.com/2015/04/12/who-caesareansectionsoclassification/. Accessed on 26 March 2023.
WHO. WHO statement on cesarean section rates, 2015. Available at: http://www.who.int/ reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/. Accessed on 28 April 2023.
Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of cesarean sections using robson's ten group classification system. Pak J Med Sci. 2021;37(2):567-71.