383. Obese primiparous women undergoing induction of labour have a higher caesarean section rate: An analysis using the Robson 10-group classification system

2018 ◽  
Vol 13 ◽  
pp. S140
Author(s):  
Lay-Kok Tan ◽  
Eng Loy Tan ◽  
Hak-Koon Tan ◽  
Kirsten J.Y. Ong
Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.


2020 ◽  
Vol 17 (4) ◽  
pp. 491-494 ◽  
Author(s):  
Rekha Poudel ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  

Background: Aims of this study was to assess the caesarean section rate and identify the indications contributing to the same using the Robson’s Ten Group Classification System at Kathmandu Model Hospital.Methods: This was a retrospective study conducted at Kathmandu Model Hospital among women who underwent caesarean section from 1 January to 31 December, 2018 and were grouped according to Ten Group Classification System. The overall caesarean section rate and the contribution of each group was calculated.Results: The overall caesarean section rate was 66.1% (494 among 747 total deliveries) in 2018. Nullipara, singleton cephalic, >= 37 weeks, spontaneous labor (Group 1) was the major (24.2%) contributor to the overall caesarean section rate followed by previous caesarean section, singleton cephalic, >=37 weeks (Group 5, 22.6%) and nullipara, singleton cephalic, >=37 weeks, induced or caesarean section before labor (Group 2, 18.8%). Also, the caesarean section rate was 49.5% in nullipara, thus increasing the trend of caesarean section for previous caesarean section in future.Conclusions: Efforts must be focused more on Group 1, 2 and 5 to decrease the increasing trend of caesarean section Promoting vaginal delivery in nullipara and facilitating vaginal birth after caesarean are the most relevant areas of intervention. Keywords: Caesarean section; Robson ten group classification system; vaginal birth after caesarean.


Author(s):  
Jishma Jose ◽  
Sendhil Coumary Arumugam ◽  
Syed Habeebullah

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.


Author(s):  
Heera Shenoy T. ◽  
Sheela T. Shenoy ◽  
Anaswara T. ◽  
Remash K.

Background: Globally, the caesarean delivery rate is rising continuously, making caesarean one of the most common surgical procedures. The Robson classification, appreciated by WHO in 2014 and FIGO in 2016 is widely accepted, risk-based, ten-group classification system (TGCS) developed specifically to assess caesarean section rates. The aim of this study was to know the rate of Caesarean section in present hospital, to analyse the Caesarean sections based on Robson’s classification and to determine the contribution and significance of each group on the overall number of Caesarean sections.Methods: All women, who gave birth by Caesarean deliveries done over a period of 1 year (January 2018-December 2018) in Travancore Medical College Hospital in South Kerala India.Results: Group 5 (previous LSCS, single, cephalic >37 weeks) made the greatest contribution to the Caesarean section rate (27.24%). The second highest contributor was Group 2 (Nulliparous, singleton, cephalic, >37 weeks induced labour or caesarean section before labour followed by Group 10 (all single cephalic <36 weeks including previous CS) 18.78%.Conclusions: Limiting the CS rate in low-risk pregnancies is key to lowering the trend of increased CS. If TGCS is used uniformly, CS rates can be compared over time and between units, both nationally and internationally.


Author(s):  
Meha K. Patel ◽  
Saloni M. Prajapati

Background: High caesarean section rate worldwide including India is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries according to characteristics of pregnancy. The objective was to analyze caesarean section rates in a tertiary care centre according to Modified Robson’s ten groups classification.Methods: This retrospective study was conducted at GMERS Gotri Medical College, Vadodara, Gujarat, India. All patients who delivered between August 2018 and March 2019, were included in the study. Women were classified in 10 groups according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caesarean rate.Results: Total number of delivery in my study institute in 8 months was 1531 out of them 456 was cesarean section, so the overall caesarean section rate was 29.78%. The main contributions to overall caesarean rate was 40.78% by group 5 (previous CS, singleton, cephalic, >37weeks) followed by 14.25% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 11.40% by group 2 (nullipara, singleton, cephalic,>37 weeks, induced or CS before labour). CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 98.4% in previous CS (group 5), 84% in nulliparous breech (group 6), 58% in multiparous breech (group 7) and least 8.2% in multipara spontaneous labour (group 3).Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.


Author(s):  
Ari Sharma ◽  
Dipika Singh ◽  
Sarika Verma ◽  
Sanjog Sharma

Background: Recent data indicate that one in five women undergo caesarean section (CS). In the last decade, there has been a dramatic increase in the caesarean section rate worldwide, which now exceeds 30% in some regions. Thus, the increasing rate of caesarean section became a matter of international public health concern. Our study aimed to classify the CS-based on Robson ten group classification system (RTGCS) criteria which will subsequently enable us to standardise the indication of CS and establish protocols to reduce the number of CS in our set up.Method: A retrospective study was conducted in ESI Hospital, New Delhi wherein Robson TGCS was used to classify CS for 15 months (January 2019 to April 2020).Results: Overall CS rate in our hospital over the specified period was 34.5%. All women with one or more previous cesareans (group V) had the maximum number of cesareans, 37%, followed by nulliparous, single, cephalic, term pregnancy (induced) i.e group II, 22.1% and nulliparous women more than 37 weeks in spontaneous labour (group I), 9.5%.Conclusions: RTGCS is easy to comprehend and reproduce. All deliveries and cesareans should be universally categorized by the Robsons TGCS. An attempt should be made to evaluate the group contributing most to the CS rate and interventions should be made accordingly.


2021 ◽  
Vol 8 (01) ◽  
pp. 37-42
Author(s):  
Srividhya R ◽  
Jhansi Rani K

BACKGROUND In current and subsequent births, Caesarean sections bear their own risks for maternal and perinatal morbidity and mortality. In contrast with vaginal delivery, Caesarean section has increased risk of blood transfusion, hysterectomy and death and the risk of uterine rupture, placenta accreta and placenta previa in future pregnancies is also increased. We wanted to analyse the Caesarean section rate using Robson ten group classification system & identify the leading groups contributing to high caesarean section rates using Robson ten group classification system. METHODS This observational descriptive study enrolled 11,090 women who underwent delivery, of whom 5117 (46.14 %) women delivered vaginally and 5973 (53.86 %) women delivered through Caesarean section. RESULTS Overall caesarean section percentage was 53.86 %. Major contributors for the CSR were Group 5, 2 and 1 in that order. CS rate in Group 5 and 1 is relatively increased. Ratio of relative size of Group 1 and 2 is 1:2 indicating a greater number of prelabour caesarean sections in nulliparous women. Caesarean section rate in Group 1 and 2 was 15.7 % and 20.1 % respectively. The main indications for caesarean sections being fetal distress, non-progressive labour and severe oligohydramnios / anamnios. Relative size of Group 1 and 5 was 47.3 % stating that most of the obstetric population was in Group 1 and 5. Caesarean section rate in Group 3 and Group 4 was relatively higher than expected; this may be due to our institute being a referral center. Group 5 contributed 45.7 % to overall caesarean section rate. CONCLUSIONS Standardisation of indication of Caesarean deliveries, regular audits and definite protocols in hospital will aid in decreasing the Caesarean section rate in hospital. KEYWORDS Kidney Size, Ultrasound Assessment, Age Groups


Author(s):  
Sudesh Agrawal ◽  
Virendar Singh Rawat

Introduction : Despite the lack of scientific evidence indicating any substantial maternal and perinatal benefits from increasing caesarean section rates, most of the studies are showing that higher rates could be linked to negative consequences in maternal and child health, still caesarean rates continues to increase worldwide, particularly in middle and high income countries, and have become a major and controversial public health concern. Therefore, we conducted this study to analyse the LSCS rate in the institute, to classify the indications of LSCS as per RTGCS and to find out strategy to decrease the prevalence of lower segment caesarean section. Material & Methods : This is a retrospective hospital based study at tertiary care centre. Data collection of one thousand pregnant females who delivered by caesarean section from the period of January 2018 onwards was assessed for the study. There are six parameters as per Robson’s classification to classify all pregnant females for caesarean section. Entire information was entered in Microsoft excel sheet and analysis were done to decrease caesarean section rate. Results : In the present study, a total of 1000 pregnant women delivered by caesarean section was taken from January 2018 onwards. The total number of deliveries during this study period was 2919 and the overall caesarean section rate was 34.25%. Most of the patients belonged to Robson’s group 1,2&5 which contributed to 65.6% to total. Conclusion :  The overall CSR in the study is 34.25% which is high as compared to international studies, contribution of repeat CS is high. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate. More analytical studies based on Robson’s 10-group classification system are needed locally, to evaluate the indications of CS within each group.  


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