scholarly journals Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System

2020 ◽  
Vol 42 (06) ◽  
pp. 310-315
Author(s):  
Sara Vargas ◽  
Susana Rego ◽  
Nuno Clode
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Hospital ◽  
Group Classification ◽  
World Health ◽  
Rate Analysis ◽  
Vaginal Deliveries ◽  
The World ◽  
Obstetric Population ◽  
Health Organization

Abstract Objective The Robson 10 group classification system (RTGCS) is a reproducible, clinically relevant and prospective classification system proposed by the World Health Organization (WHO) as a global standard for assessing, monitoring and comparing cesarean section (CS) rates. The purpose of the present study is to analyze CS rates according to the RTGCS over a 3-year period and to identify the main contributors to this rate. Methods We reviewed data regarding deliveries performed from 2014 up to 2016 in a tertiary hospital in Portugal, and classified all women according to the RTGCS. We analyzed the CS rate in each group. Results We included data from 6,369 deliveries. Groups 1 (n = 1,703), 2 (n = 1,229) and 3 (n = 1,382) represented 67.7% of the obstetric population. The global CS rate was 25% (n = 1,594). Groups 1, 2, 5 and 10 were responsible for 74.2% of global CS deliveries. Conclusion As expected, Groups 1, 2, 5 and 10 were the greatest contributors to the overall CS rate. An attempt to increase the number of vaginal deliveries in these groups, especially in Groups 2 and 5, might contribute to the reduction of the CS rate.

A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System

2016 ◽  
Vol 8 (3) ◽  
pp. 212-216
Author(s):  
Indra Bhati ◽  
Akriti Jha ◽  
Nishu Agarwal
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Group Classification ◽  
World Health ◽  
Group V ◽  
Global Epidemic ◽  
Nulliparous Women ◽  
Group I ◽  
Group 2 ◽  
Health Organization

ABSTRACT Introduction Cesarean section (CS) is the most common obstetric surgery and one of the most rewarding surgeries performed. The number of CSs has been growing rapidly, and concern has been expressed at the growing rate in some countries, with some referring to it as an emerging “global epidemic.” Aim The purpose of this study was to study the incidence and analyze different indications of CS in our institution and to compare the frequency of CS in Robson's ten group classification system (TGCS). Materials and methods A prospective hospital-based study for a duration of 3 months (January 2012 to March 2012) was conducted in the Department of Obstetrics and Gynecology, Umaid Hospital, Jodhpur. All patients admitted beyond 20 weeks gestation were included in the study, and record of all births during this period was evaluated. Each delivery was then classified into one of ten mutually exclusive categories according to obstetric characteristics. The information was used to identify the group that accounted for largest proportion of women or group that contributed most to CS and identify the areas for potential modification. Results We found cesarean rate of 28.6% during our study period, which is well above the World Health Organization guidelines. Group V (single, term, cephalic, previous CS) was the largest contributor to CS rates (30.4%). Groups I and II were the 2nd and 3rd largest contributors, i.e., 27.5 and 17.5% respectively. Maximum CS rate of 100% was found in group IX (abnormal lie), which was within the expected range. Group 2 had CS rate more than that of group I, and IV had a rate more than that of group I, which indicates that induction and cesarean before labor increases cesarean rate in both multiparous and nulliparous women. In our study, Robson's TGCS demonstrated the need to focus on groups I, II, III, and V because the contribution of these groups to overall cesarean rate was 82%. Clinical significance Ten group classification system was found to be a useful framework for auditing and analyzing different CS rates and their reasons. This will help in not only identifying the priority areas for the changes in clinical practice but also reducing cesarean rate. How to cite this article Bhati I, Jha A, Agarwal N. A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System. J South Asian Feder Obst Gynae 2016;8(3):212-216.

scholarly journals OBSTETRIC AUDIT BASED ON ROBSON TEN-GROUP CLASSIFICATION SYSTEM

2018 ◽  
Vol 5 (1) ◽  
pp. 45-48
Author(s):  
Anatoly E. Miroshnikov ◽  
N. A Zharkin
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Group Classification ◽  
World Health ◽  
Initial State ◽  
Cesarean Section Delivery ◽  
Main Determinants ◽  
Health Organization ◽  
Abdominal Delivery

The problem of the increase in the frequency of Cesarean section delivery has not been resolved yet. Firstly, a large variation in the initial state of puerpera, secondly, a wide variety of indications to the operation fail to allow revealing main determinants. In order to develop and implement effective measures to reduce the rate of the abdominal delivery, an understandable, logical classification of patients is necessary. The World Health Organization recommends the use of Robson Ten-Group Classification System. This study executed with the use of the Robson scale reveals the contingent of patients in whom the decline in the frequency of abdominal deliveries is possible. The authors propose a set of measures aimed at reducing the rate of Cesarean section in institutions of the second level.

scholarly journals Optimizing the use of cesarean section in Argentina: design and methodology of a formative research for the development of interventions

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Silvina Ramos ◽  
Mariana Romero ◽  
Carla Perrotta ◽  
Yanina Sguassero ◽  
Cecilia Straw ◽  
...  
Keyword(s):  
Information System ◽  
Cesarean Section ◽  
World Health Organization ◽  
Health Professionals ◽  
Formative Research ◽  
World Health ◽  
Cesarean Section Rate ◽  
The World ◽  
Health Organization ◽  
Type Of Delivery

Abstract Background While cesarean section is an essential life-saving strategy for women and newborns, its current overuse constitutes a global problem. The aim of this formative research is to collect information from hospitals, health professionals and women regarding the use of cesarean section in Argentina. This article describes the methodology of the study, the characteristics of the hospitals and the profile of the participants. Methods This formative research is a mixed-method study that will be conducted in seven provinces of Argentina. The eligibility criteria for the hospitals are (a) use of the Perinatal Information System, (b) cesarean section rate higher than 27% in 2016, (c) ≥ 1000 deliveries per year. Quantitative and qualitative research techniques will be used for data collection and analysis. The main inquiry points are the determining factors for the use of cesarean section, the potential interventions to optimize the use of cesarean section and, in the case of women, their preferred type of delivery. Discussion It is expected that the findings will provide a situation diagnosis to help a context-sensitive implementation of the interventions recommended by the World Health Organization to optimize cesarean section use. Trial registration IS002316 Plain English Summary Cesarean section is an essential medical tool for mothers and their children, but nowadays its overuse is a problem worldwide. Our purpose is to get information from hospitals, health professionals and women about how cesarean section is used in Argentina. In this protocol we describe how we will carry out the study and the characteristics of the hospitals and participants. We will implement this study in seven provinces of Argentina, in hospitals that have more than 1,000 births each year, had a cesarean section rate higher than 27% in 2016 and use the Perinatal Information System. We will gather information using forms, surveys and interviews. We want to identify the factors that decide the use of a cesarean section, the potential interventions that can improve the use of cesarean section and, in the case of women, the type of delivery they prefer. We expect that this study will give us a diagnosis of how cesarean section is used in Argentina, and that this will help to apply the interventions that the World Health Organization recommends to optimize the use of cesarean section in our specific context.

scholarly journals Classification of WHO Essential Oral Medicines for Children Applying a Provisional Pediatric Biopharmaceutics Classification System

Pharmaceutics ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 567 ◽  
Author(s):  
Jose-Manuel delMoral-Sanchez ◽  
Isabel Gonzalez-Alvarez ◽  
Marta Gonzalez-Alvarez ◽  
Andres Navarro ◽  
Marival Bermejo
Keyword(s):  
World Health Organization ◽  
Classification System ◽  
Biopharmaceutics Classification System ◽  
Essential Medicines ◽  
World Health ◽  
Oral Drug ◽  
Essential Medicines List ◽  
The World ◽  
Health Organization ◽  
Biopharmaceutics Classification

The objective was using the Essential Medicines List for children by the World Health Organization (WHO) to create a pediatric biopharmaceutics classification system (pBCS) of the oral drugs included in the Essential Medicines List by the World Health Organization and to compare our results with the BCS for adults (aBCS). Several methods to estimate the oral drug dose in different pediatric groups were used to calculate dose number (Do) and solubility (high/low). The estimation of the gastrointestinal water volume was adapted to each pediatric group. Provisional permeability classification was done by comparison of each drug lipophilicity versus metoprolol as the model drug of high permeability. As a result, 24.5% of the included drugs moved from the favorable to unfavorable class (i.e., from high to low solubility). Observed changes point out potential differences in product performance in pediatrics compared to adults, due to changes in the limiting factors for absorption. BCS Class Changes 1 to 2 or 3 to 4 are indicative of drugs that could be more sensitive to the choice of appropriate excipient in the development process. Validating a pBCS for each age group would provide a valuable tool to apply in specific pediatric formulation design by reducing time and costs and avoiding unnecessary pediatric experiments restricted due to ethical reasons. Additionally, pBCS could minimize the associated risks to the use of adult medicines or pharmaceutical compound formulations.

The World Health Organization 1973 classification system for grade is an important prognosticator in T1 non-muscle-invasive bladder cancer

2018 ◽  
Vol 122 (6) ◽  
pp. 978-985 ◽  
Author(s):  
Elisabeth E. Fransen van de Putte ◽  
Judith Bosschieter ◽  
Theo H. van der Kwast ◽  
Simone Bertz ◽  
Stefan Denzinger ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
World Health Organization ◽  
Classification System ◽  
World Health ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The World ◽  
Muscle Invasive ◽  
Health Organization

Papillary Breast Tumors: Continuing Controversies and Commentary on WHO's 2019 Criteria and Classification

2021 ◽  
pp. 106689692110358
Author(s):  
Ami Patel ◽  
Raza S. Hoda ◽  
Syed A. Hoda
Keyword(s):  
Breast Neoplasms ◽  
World Health Organization ◽  
Papillary Carcinoma ◽  
Diagnostic Criteria ◽  
Classification System ◽  
Breast Tumors ◽  
High Rate ◽  
World Health ◽  
The World ◽  
Health Organization

The category of papillary breast tumors includes a limited number of entities. Nonetheless, this relatively uncommon group of tumors seems to instigate a disproportionate degree of diagnostic disquiet. As a group, papillary breast tumors suffer from a relatively high rate of discordant interpretation. The latter is due to the inherent complexity of the lesions compounded by conflicting criteria as well as simmering controversies. For instance, “encapsulated” papillary carcinoma remains contentious with regards to whether these are noninvasive or not, and the assessment of the extent of the invasive versus noninvasive components in many solid papillary carcinomas can be problematic. The latest classification system of breast tumors enunciated by the World Health Organization (WHO), that is, Breast Tumors, which appeared in 2019, mainly sought to incorporate advances in basic and clinical sciences into diagnostic criteria for the entire spectrum of breast neoplasms—including papillary ones. The latter category of tumors is discussed at some length in Breast Tumors; however, it still appears to suffer from some lack of clarity in its subclassification. It is our intent in this communication to provide an overview of the controversies around papillary breast tumors, and offer comments on its coverage in Breast Tumors—so that any tangible or perceived ambiguities therein could be addressed in its next edition.

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

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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