Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20203339Keywords:
Caesarean section, Robson’s classificationAbstract
Background: There has been a considerable increase in the rate of caesarean sections in the past few decades. Some demographers have argued that this increase is largely affected by the uprising trend of new medically indicated caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. This classification is known as Robson’s classification which has ten groups.
Methods: This is a retrospective study which was carried out at Civil Hospital, Karimnagar. The study group included all live births and still births of at least 500 gm birth weight or at least 28 weeks of gestation at Civil Hospital, Karimnagar during the period from October 2019 to December 2019. The data collected was analysed using simple statistical methods like percentage and proportion. The data was grouped according to the Robson’s 10 group classification system. The overall caesarean section rate, size of each group and the relative contribution of each group to the overall CS rate were calculated.
Results: The total number of deliveries during the study period was 2493. Out of these, the number of caesarean deliveries was 1345. The caesarean section rate was calculated to be 53.95%. The group 5 (multiparous with at least one previous uterine scar with single cephalic pregnancy ≥37 weeks of gestation) contributed to 38.07% of the total caesarean section rate which is the highest.
Conclusions: A regular audit into the number and indications of caesarean sections will definitely help in decreasing the primary and repeat caesarean sections.
References
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.
Boyle A, Reddy UM. Epidemiology of caesarean delivery: the scope of the problem. Semin Perinatol. 2012;36:308-14.
WHO statement on caesarean section rates; WHO/RHR/15.02. Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_ health/cs-statement/en/. Accessed on 12th April 2020.
FIGO working group on challenges in care of mothers and infants during labour and delivery. Best practice advice on the 10 - group classification system for caesarean deliveries. Int J Gynecol Obstet. 2016;135(2):232-3.
Robson MS. Classification of Caesarean sections. Fetal Mat Med Rev. 2001;12(1):23-39.
Makhana V, Goender L, Moodley J. Utility of Robson ten group classification system to determine appropriateness of caesarean sections at a rural region hospital in Kwazulu-Natal, South Africa. South Africa Med J. 2015;105:4.
Ray A, Jose S. Analysis of caesarean section 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.
Vogel JP, Betran AP, Souza JP. Use of Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Global Health. 2015;3(5):269-70.
Royal College of obstetricians and gynaecologists, birth after previous caesarean birth (green top guideline 45), RCOG, London, UK; 2015.
The society of obstetricians and gynaecologists of Canada (SOGC). Guidelines for vaginal birth after previous caesarean birth 2005. Available at: http://sogc.org/wp-content/uploads/2013/01/155E-CPG-February2005.pdf. Accessed on 24th April 2020.
The American College of Obstetricians and Gynaecologists (ACOG). Vaginal birth after previous caesarean delivery. 2010, Available at: http://www.acog.org/Resources-And-Publications/ Practice-Bulletins/Committee-on-Practice-Bulletins-Obstetrics/Vaginal-birth-After-Previous-Caesarean-Delivery. Accessed on 25th April 2020.
Ray CL, Blondel B, Prunet C, Khireddine I, Tharaux CD, Goffinet F. Stabilising the caesarean rate: which target population? BJOG. 2014;122(5):690-9.
Zhang J, Landy HJ, Branch DW et al. Contemporary patterns of spontaneous labour with normal neonatal outcomes. Obstet Gynaecol. 2010;116(6):1281-7.
Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, William AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multicentre trial. Lancet. 2000:356(9239);1375-83.
Reitberg CC, Elferink Stinkens PM, Visser GH. The effect of term breech trial on medical intervention behaviour and neonatal outcome in The Netherlands: an analysis of 35,453 term breech infants. BJOG. 2005;112(2):205-9.
Hehir MP. Trends in vaginal breech delivery. J Epidemiol Comm Health. 2015;69(12):1237-9.
Kathpalia SK, Singh Y, Sharma R. Outcome of external cephalic version in breech presentation. MJAFI. 2012;68:151-3.
Thomas J, Paranjothy S. Royal College of obstetricians and gynaecologists. Clinical Effectiveness support unit. The National Sentinel Caesarean Section Audit Report. RCOG press; 2001.
Stavrou EP, Ford JB, Shand AW, Morris JM, Roberts CL. Epidemiology and trends for caesarean section births in New South Wales, Australia: a population based study. BMC Preg Childbirth. 2011;11:8.
Farine D, Shepherd D. Classification of Caesarean sections in Canada: the modified Robson criteria. J Obstet Gynaecol Canada. 2012;34:976-9.
