Evaluating vaginal-delivery rates after previous cesarean delivery using the Robson 10-group classification system at a tertiary center in Brazil

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this: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):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Use of the Robson Ten Group Classification System to categorise operative vaginal delivery

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/ajo.13169 ◽

2020 ◽

Vol 60 (6) ◽

pp. 858-864

Author(s):

Bobby D. O’Leary ◽

Daniel T. Kane ◽

Nicholas Kruseman Aretz ◽

Michael P. Geary ◽

Fergal D. Malone ◽

...

Keyword(s):

Vaginal Delivery ◽

Classification System ◽

Group Classification ◽

Operative Vaginal Delivery

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Examining Cesarean Delivery Rates by Race: a Population-Based Analysis Using the Robson Ten-Group Classification System

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-020-00842-3 ◽

2020 ◽

Cited By ~ 1

Author(s):

Elise G. Valdes

Keyword(s):

Cesarean Delivery ◽

Classification System ◽

Population Based ◽

Group Classification

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Cesarean delivery in the United States 2005 through 2014: a population-based analysis using the Robson 10-Group Classification System

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2018.04.012 ◽

2018 ◽

Vol 219 (1) ◽

pp. 105.e1-105.e11 ◽

Cited By ~ 37

Author(s):

Mark P. Hehir ◽

Cande V. Ananth ◽

Zainab Siddiq ◽

Karen Flood ◽

Alexander M. Friedman ◽

...

Keyword(s):

United States ◽

Cesarean Delivery ◽

Classification System ◽

The United States ◽

Population Based ◽

Group Classification

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Trial of labor after previous cesarean delivery (TOLAC) and association of BMI and previous vaginal delivery with frequency of VBAC

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v15i4.21687 ◽

2016 ◽

Vol 15 (4) ◽

pp. 546-550 ◽

Cited By ~ 1

Author(s):

Huma Tasleem ◽

Haider Ghazanfar

Keyword(s):

Cesarean Section ◽

Success Rate ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Health Centre ◽

Tertiary Care ◽

Vaginal Birth ◽

Trial Of Labor ◽

Emergency Cesarean ◽

Previous Cesarean

Objectives: To determine the frequency of successful Vaginal Birth after One Cesarean Section in our tertiary care institution and to determine the causes of its failure.Material and Methods: This study was conducted in department of Obstetrics and Gynecology of Shifa International Hospital and Shifa Foundation Community Health Centre Islamabad Pakistan from Feb 2011 to Dec 2014. This study included 592 patients who presented in labor room emergency reception of Obs/Gynae department at term with previous one scar having fulfilled the laid down inclusion criteria for VBAC during ante-natal care. The patients were admitted in hospital and were allowed to proceed for spontaneous labor under vigilant monitoring on complications of trial of scar. Immediate emergency cesarean sections were performed, where indicated.Results: Out of 592 patients 70.7% were delivered vaginally after previous one cesarean section and 29.3% had emergency cesarean section. Leading indications for repeat cesarean section was fetal distress, failure to progress and scar tenderness. No maternal and fetal complication occurred in our study. The success rate of Trial of labor after one previous cesarean delivery was lower in obese (64.38%) as compared to non-obese women (82.06%) (p<0.001). Women with previous successful vaginal delivery had a success rate of 88.2% compared with 62.25% in women without such a history (OR 4.4; 95% CI 2.7-7.2 p <0.001).Conclusion: Vaginal birth after one lower segment cesarean section should be encouraged with vigilant monitoring provided no obstetric contra-indication to vaginal birth exists.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.546-550

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Robsons Ten Group Classification of Cesarean Section at a Tertiary Center in Nepal

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v19i1.2694 ◽

2021 ◽

Vol 19 (1) ◽

pp. 91-96

Author(s):

Gehanath Baral ◽

Alish Shrestha ◽

Arati Sah ◽

Aswani Kumar Gupta

Keyword(s):

Cesarean Section ◽

Classification System ◽

Group Classification ◽

Quality Of Data ◽

Cesarean Birth ◽

Robson Classification ◽

Tertiary Center ◽

Preterm Group ◽

Obstetric Population

Background: Increasing trend in Ceasarean birth is the issue of both demand and supply side. One of the recommended tools to characterize every pregnancy admitted for childbirth is Robson ten-group classification system that may evaluate obstetric practice. The aim of the study was to assess the cesarean section pattern based on Robson’s classification in a central referral hospital.Methods: A retrospective census of childbirths at Paropakar Maternity and Women’s Hospital in Kathmandu performed from September 2018 to February 2019 based on obstetric record. Robson ten-group classification system was the research tool to collect data and Robson Classification Report Table was used to evaluate the data.Results: There were 10500 births with 34% (32-35%) overall cesarean section rate. Excluding spontaneous and induced labor the supposedly total prelabor CS is 14.5%. Group 1+2+3 size is 81% and 21% CS; 5+10 had 11.3% and 23.3% respectively. Prelabor CS (2b+4b) is 3.54% and additional 11% from malpresentation and preterm. Group CS rate from Class 5 onwards, and ratio of 1 and 2 are as recommended by Robson; 67% of CS were not picked up by Robson class due to indications evolved as the labor progresses and the attributes not pre-classified.Conclusions: The assessed quality of data and the type of obstetric population by Robson reference values prove this study as a representative research. But the indications of cesarean sections can be predicted for only one-third of pregnancy attributes classified by Robson class. To supplement this tool to reduce rising cesarean birth requires audit of indications at decision making level.Keywords: Cesarean section; indication; prediction; robson classification

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Analysis of Cesarean Delivery at Ain Shams Maternity Hospital Using the Ten Group Classification System

QJM ◽

10.1093/qjmed/hcab115.019 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hazem Amin Elzenini ◽

Radwa Mansour ◽

Ismail Mohamed Ismail Elnagar

Keyword(s):

Cesarean Delivery ◽

Classification System ◽

Mode Of Delivery ◽

Multiple Pregnancy ◽

Fetal Distress ◽

Maternity Hospital ◽

Group Classification ◽

Medical Complication ◽

Quality Of Data ◽

Robson Classification

Abstract Background Cesarean section is an invasive surgical procedure in which a baby is delivered through an abdominal and uterine incision & carries with it many immediate and delayed morbidity and mortality risks. Objective To evaluate the feasibility of using the Robson Ten Group Classification System (TGCS) for cesarean delivery indications at Ain Shams Maternity hospital. Methods This is a retrospective study on women who delivered by cesarean delivery at Ain Shams Maternity hospital between July 1, 2016 and June 30, 2018. All patient files have been revised and data has been collected then categorized. The indications for this mode of delivery: suspected fetal growth impairment, fetal distress, preeclampsia/eclampsia, pregnancy duration in weeks or more pre-partum hemorrhage, cephalopelvic disproportion, dystocia, failure of progress, multiple pregnancy, suspected/imminent uterine rupture, breech or other malpresentations, previous cesarean delivery, failed induction of labor, tubal ligation, sterilization, maternal request genital herpes, extensive condyloma, any other obstetric complication, any other fetal indication or any other maternal medical complication. Results 15808 women delivered in the hospital during the study period, The CS rate was 58.04%. According to the Robson classification, Group5 and Group 10 were the most represented groups (31.72% and 29.91% of population, respectively). The major contributors to the CS rate were group 5 (27.10%), group10 (14.02%).The most commonly reported indications for CS included past CS, suspected fetal distress, preeclampsia, eclampsia.These suggested the need for further discussion on CS practices Conclusion This study provides an example on how the WHO manual for Robson classification can be used in an action-oriented manner for developing recommendations for improving the QoC, and the quality of data collected.

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