An audit of caesarean section rate based on Robson’s ten group classification system

Jishma Jose; Sendhil Coumary Arumugam; Syed Habeebullah

doi:10.18203/2320-1770.ijrcog20202712

Authors

Jishma Jose Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and RI, Puducherry, India
Sendhil Coumary Arumugam Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and RI, Puducherry, India
Syed Habeebullah Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and RI, Puducherry, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202712

Keywords:

Audit, Caesarean section, Robson's

Abstract

Background: Caesarean section (CS) rates are rising worldwide and is a major public health concern. There is lack of evidence supporting the maternal and neonatal benefits with the increasing CS rates. Robson’s ten group classification system serves as an initial structure with which caesarean section rates can be analysed. RTGCS helps us to analyse and allow us to bring changes in our practice.

Methods: This was a hospital based cross sectional study conducted over a period of 10 months during the year 2018, which involved 1478 pregnant women, out of which 693 underwent CS, those who underwent CS were grouped according to Robson’s Ten group classification system and the data was collected and analyzed.

Results: 693 women underwent CS and the overall section rate was 46.88%. Group 5 (previous LSCS) and Group 2 (nulliparous, >37 weeks, induced) contributed the maximum to the overall CS rates (33.9% and 26.3% respectively). The most common indication for caesarean section was previous LSCS (38%), fetal distress (19.2%) and meconium stained liquor (13.7%).

Conclusions: Robson’s ten group classification system helps us in auditing the caesarean section rates. Group 5 and 2 contributes the maximum for caesarean section rates. Encouraging and adequate counselling for VBAC, proper training of obstetricians in CTG interpretation would reduce the caesarean section rates.

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References

Dosa L. Caesarean section delivery, an increasingly popular option. Bull World Health Organ. 2001;79(12):1173.

Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98-113.

Kaimal AJ, Kuppermann M. Decision making for primary cesarean delivery: the role of patient and provider preferences. Semin Perinatol. 2012;36(5):384-9.

Tanaka K, Mahomed K. The ten-group Robson classification: a single centre approach identifying strategies to optimise caesarean section rates. Obstet Gynecol Inter. 2017;2017.

Radhakrishnan T, Vasanthakumari KP, Babu PK. Increasing trend of caesarean rates in India: evidence from NFHS-4. JMSCR. 2017;5(8):26167-76.

Robson M. The ten-group classification system (TGCS) - a common starting point for more detailed analysis. An Int J Obstet Gynaecol. 2015;122(5):701-1.

Ray A, Jose S. Analysis of caesarean-section rates according to Robson’s ten group classification system and evaluating the indications within the groups. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):447-51.

Jacob KJ, Jayaprakash M, Hibina KP. TMC (Thrissur Medical College) modified Robson criteria for caesarean sections. Int J Reprod Contracept Obstet Gynecol. 2017;6:5038-43.

Reddy AY, Dalal A, Khursheed R. Robson ten group classification system for analysis of cesarean sections in an Indian Hospital. Res J Obstet Gynecol. 2018;11(1):1-8.

Zimmo MW, Laine K, Hassan S, Bottcher B, Fosse E, Ali-Masri H, et al. Caesarean section in palestine using the Robson ten group classification system: a population-based birth cohort study. BMJ Open. 2018;8:e022875.

Jogia P, Lodhiya K. Analysis of caesarean sections according to modified Robson’s ten group classification system at a tertiary care centre in Western India. Int J Reprod Contracept Obstet Gynecol. 2019;8:433.

Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynecol. 2018;7:4674.

Prabhavathi V, Krishnamma BS, Prasad DKV, Bhavya K, Satyavathi R. Audit of caesarean deliveries in a tertiary care hospital of northern Andhra Pradesh using modified Robson criteria. In Int J Reprod Contracept Obstet Gynecol. 2018:2796-801.

Tura AK, Pijpers O, de Man M, Cleveringa M, Koopmans I, Gure T, et al. Analysis of caesarean sections using Robson 10-group classification system in a university hospital in eastern Ethiopia: a cross-sectional study. BMJ Open. 2018;8(4):e020520.

Mbaye M, Gueye M, Gueye MDN, Niang NKS, Moreau JC. Analysis of cesarean section rate according to Robson’s classification in an urban health centre in Senegal. Int J Reprod Contracept Obstet Gynecol. 2017;4(4):1100-2.

Yadav RG, Maitra N. Examining cesarean delivery rates using the Robson’s Ten-group classification. J Obstet Gynaecol India. 2016;66(Suppl 1):1-6.

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. 2017;4(3):745-9.

Bolognani CV, Reis LB de SM, Dias A, Calderon I de MP. Robson 10-groups classification system to access C-section in two public hospitals of the Federal District/Brazil. PLoS ONE. 2018;13(2):e0192997.

Litorp H, Kidanto HL, Nystrom L, Darj E, Essén B. Increasing caesarean section rates among low-risk groups: a panel study classifying deliveries according to Robson at a university hospital in Tanzania. BMC Preg Childbirth. 2013;13:107.

Sasikala A, Raghavan S, Mishra N, Khatoon S, Bupathy A, Rani R. Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid. Indian J Pediatr. 1995;62(1):63-7.