scholarly journals Using the Robson Classification to Explain the Fluctuations in Cesarean Section

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
H. Cammu ◽  
E. Martens ◽  
G. Van Maele
Keyword(s):  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Induced Labor ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Absolute ◽  
Group 5 ◽  
Group 2

Purpose. As the rate of cesarean sections (CS) continues to rise in Flanders (northern part of Belgium), it is important to understand the reasons behind this evolution and to find ways to achieve appropriate CS rates. For this analysis, we categorized CS changes between 1992 and 2016, applying the Robson 10-Group Classification System (TGCS). We also applied the TGCS to analyze the information of the only clinics where between 2008 and 2016, the absolute CS rate had fallen by more than two percent. Methods. This paper is based on a population-based cross-sectional study. Robson’s TGCS was used to analyze CS rates for the years 1992, 2000, 2008, and 2016, using the Flemish population-based birth register. Results. Between 1992 and 2016, the overall CS rate increased from 11.8% in 1992 to 20.9% in 2016. The major contributors to that increase were (a) single, cephalic nulliparous women, at term in spontaneous labor (Robson group 1); (b) single, cephalic nulliparous women, at term in induced labor or CS before labor (group 2); and (c) multiparous women with single cephalic at term pregnancy with history of CS (group 5). In the subgroup of the seven clinics where the collective CS rate had decreased from 23.2% in 2008 to 19.3% in 2016, the main contributors to this decrease were Robson groups 1 and 2. Conclusions. The CS increase in Flanders between 1992 and 2016 is mainly the result of the absolute CS increase in the childbirth of nulliparous women with a single cephalic baby at term in spontaneous or induced labor and in women with a single cephalic presentation at term and a previous CS. Further research in these aforementioned groups is needed to identify the real reasons for the CS increase.

scholarly journals Analysis of Caesarean-Section rates according to Robson's ten group classification system and evaluating the indications within the groups

2017 ◽  
Vol 6 (2) ◽  
pp. 447 ◽  
Author(s):  
Amita Ray ◽  
Sumy Jose
Keyword(s):  
Classification System ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
Care Hospital ◽  
Cross Sectional ◽  
The Absolute ◽  
Group 5 ◽  
Group 2

Background: With Caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates.Methods: This was a cross sectional study for a period of 24 months at a tertiary care hospital in a tribal area of Kerala South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group.Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 38% of the total Caesareans. Followed by Group 8 and 10. All four added contributed to 63% of the section rate The least contribution was by Group 3. Groups 6, 7 and 9 by themselves did not contribute much but within their groups had a 100% C-Section rate.Conclusions: The contribution of the various Robson's Group to the absolute C-Section rates needs to be looked into. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for dystocia and non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.

scholarly journals Discrimination by parity is a prerequisite for assessing induction of labour outcome – cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson
Keyword(s):  
Caesarean Section ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Previous Caesarean Section ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group 3

Abstract Background To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women. Methods Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study using the Robson 10 group classification for the year 2016. Results In the total number of 8851 women delivered in 2016, the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.84% (151/1925) and 32.63% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.37% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B (Robson M, Fetal Matern Med Rev, 12; 23–39, 2001) were 3.91% (133/3397) and 2.86% (100/3494), of the respective single cephalic cohort at term. Conclusion The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.

scholarly journals Appropriate cesarean rates using Robson’s Ten-Group Classification System in a Brazilian private practice

2021 ◽  
Author(s):  
Andrea Silveira de Queiroz Campos ◽  
Daphne Rattner ◽  
Carmen Simone Grilo Diniz
Keyword(s):  
Access To Health Care ◽  
Obstetric Care ◽  
Multidisciplinary Care ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Cesarean Sections ◽  
Cross Sectional ◽  
Childbirth Experience ◽  
Group 5 ◽  
Group 2

Abstract Background The increasing rates of cesarean sections (CS) in places with adequate access to health care are a global concern because they are related to higher rates of maternal and neonatal complications and do not provide a positive childbirth experience for women. The objective is to highlight the possibility of achieving CS rates acceptable by WHO standards, such as Nordic countries, following evidence-based protocols in Brazil. Methods A cross-sectional study evaluated CS rates by Robson Groups for women who sought vaginal delivery in a private health practice in Brazil, comparing the rates with Swedish data. A collaborative practice with midwives and obstetricians adopting evidence-based guidelines was offered. The overall CS rate, CS rate by Robson group, contribution of each Robson group to the overall CS rate, clinical and nonclinical interventions and vaginal birth, pre-labour CS and intrapartum CS proportions were estimated. The expected CS rate for the population was calculated by the WHO c-model tool. The analysis used Microsoft EXCEL and the software "R Studio" (version 1.2.1335. 2009-2019). Results The overall CS rate was 15.1% (as expected by the WHO c-model tool) in a population composed of 43.7% women in Robson Group 1, 11.4% in Group 2 and 14.9% in Group 5, the greatest responsible for higher rates of CS, who altogether contributed to 75.4% of all cesarean sections. Conclusions Multidisciplinary care following evidence-based protocols, associated with a high motivation of both women and professionals of childbirth care for a vaginal route for delivery, may lead to a significant and safe reduction of CS rates, obtaining better results even in contexts such as Brazil, where there is high medicalization of obstetric care and excess of CS.

scholarly journals Discrimination by parity is a prerequisite for assessing induction of labour outcome – cross-sectional study

2020 ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson
Keyword(s):  
Caesarean Section ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Previous Caesarean Section ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group 3

Abstract Background: To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women Methods: Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study [BD1] using the Robson 10 group classification2 for the year 2016.Results: In the total number of 8851 women delivered in 2016[BD2] , the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.8% (151/1925) and 32.6% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.4% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B2 were 3.9% (133/3397) and 2.8% (100/3494), of the respective single cephalic cohort at term.Conclusion: The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.

scholarly journals Differences in Inter-Rectus Distance and Abdominopelvic Function between Nulliparous, Primiparous and Multiparous Women

2021 ◽  
Vol 18 (23) ◽  
pp. 12396
Author(s):  
Mercè Balasch-Bernat ◽  
Sofía Pérez-Alenda ◽  
Juan J. Carrasco ◽  
Begoña Valls-Donderis ◽  
Lirios Dueñas ◽  
...  
Keyword(s):  
Muscle Function ◽  
Cross Sectional Study ◽  
Postpartum Women ◽  
Abdominal Muscles ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Ultrasound Assessment ◽  
Primiparous Women

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women.

Analysis of caesarean section rates using Robsons ten group classification: the first step

2017 ◽  
Vol 6 (8) ◽  
pp. 3481 ◽  
Author(s):  
Sowmya Koteshwara ◽  
Sujatha M. S.
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Cross Sectional ◽  
Medical College ◽  
Relative Contribution ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: The Caesarean section (CS) rate is steadily increasing worldwide including India. The overall CS rates are reported but rarely the women are classified. According to WHO Robson ten –group classification is useful as a global standard for assessing, monitoring and comparing cesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robsons classification) and analyzing the CS rate in each group.Methods: This was a cross sectional study conducted at JSS Medical College, Mysore. The data was collected for all women delivering in hospital from January 2016-December 2016 and the women were classified according to Robsons 10 group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to CS rate from each group was calculated.Results: Among a total of 5016 women delivering during the study period 37.65% of women were delivered by CS. Maximum no of pregnant women belonged to primigravida group (group 1 and 2). Major contributor to CS rate were primigravida (group 2) at 32.2%. Next contributors were group 5 and group 1 at 28.9 % and 18.6% respectively. Overall the three groups 1, 2 and group 5 contributed to 79.7% of the CS rate while the other group contributed to only 21.3% of CS rate.Conclusions: Applying Robsons criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing primary CS rate and increasing VBAC rates will help to reduce CS rate. 

scholarly journals Rates and Indications of Cesarean Section Using the Robson Classification in a University Hospital in Southern Thailand 2014-2016

2020 ◽  
Author(s):  
Jarawee Sukmanee ◽  
Tippawan Liabsuetrakul ◽  
Krantarat Peeyananjarassri
Keyword(s):  
Cesarean Section ◽  
Healthcare Providers ◽  
Breech Presentation ◽  
University Hospital ◽  
Cross Sectional ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Southern Thailand ◽  
Multiparous Women ◽  
Group 1

Objective: To identify the rates and indications of cesarean section (CS) using the Robson classification during 2014- 2016 in a university hospital in southern Thailand. Material and Methods: A cross-sectional study of women who delivered between January 1, 2014 and December 31, 2016 was conducted. The data were analyzed using the Robson classification. Results: A total of 10,474 births were included in the analysis. The overall CS rate was 55.5%. The trends of CS rates in most Robson classification groups over the 3-year period were static. The CS rates in nulliparous or multiparous women with induction of labor decreased over the 3-year period, while the rate in multiparous women with fetal breech presentation increased. Women with previous cesarean section (Robson group 5) were the largest contributor to the overall CS rate (32.1%), followed by the nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation in spontaneous labor (Robson group 1) (24.5%). Cephalopelvic disproportion and fetal distress were the most common indications for CS in Robson group 1. Conclusion: The CS rates in our study were high in all groups during the 3-year period, with static trends in most groups. The Robson classification is a feasible tool for monitoring CS rates in our setting. Feedback of these findings to healthcare providers and policy makers is advised.

scholarly journals Indications and practices of Cesarean Sections in a French region – The Robson classification

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Laurent ◽  
A I Lecuyer ◽  
S Baron ◽  
C Diguisto ◽  
D Turpin ◽  
...  
Keyword(s):  
Breech Presentation ◽  
Cross Sectional Study ◽  
Data Repository ◽  
National Guidelines ◽  
Cross Sectional ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Scarred Uterus ◽  
French Region

Abstract Background Cesarian-section (CS) deliveries, although sometimes vital, are associated with increasing immediate- and long-term maternal and/or neonatal risks. The objective was to describe the indications of scheduled CS, measure the potentially avoidable CS and study the rate variations between maternities in one French region, Centre Val-de-Loire (CVL). Methods A cross-sectional study was conducted from September 2016 to February 2017. Information about all CS performed in the maternities of the region was collected: medical history, indication, schedule. Data collection was completed with the 2016 regional birth data repository (25,864 deliveries, including 19.2% of CS, among which 7.0% were scheduled). CS were classified according to the pre-existing risk high or low of CS as defined by the Robson classification. Results During the study period, 1,979 CS (18.6% of deliveries) were performed, of which 762 were scheduled (7.1% of deliveries). The main indications for planning a CS were: scarred uterus (60%, of which 56% with only one previous CS) or breech presentation (25%), considered at high risk of CS according to the Robson classification. For these two contexts, the regional birth repository showed decreasing scheduled CS rates from high to low level of maternities’ expertise. Remarkly, 22 nulliparous women with a single cephalic pregnancy in spontaneous labor before term (Robson’s low risk of CS) had a CS performed for unfavorable pelvimetry (0.2% of deliveries). Conclusions This study allowed identifying specific potential interventions: targeted CS on scarred uterus with only one previous CS or breech presentation, as recommended by national guidelines, and targeted use of radiologic pelvimetry. The Robson classification must be widely used to assess practices through cautious maternity comparisons to improve quality of care. Key messages Although potentially avoidable c-sections are rare, interventions were identified: targeted CS on uterus with one previous CS or breech presentation, targeted use of radiologic pelvimetry. The Robson classification must be widely used to assess practices, in order to improve healthcare quality.

scholarly journals Maternal and Fetal Outcome in Gestational Diabetes Mellitus

2021 ◽  
Vol 16 (2) ◽  
pp. 18-21
Author(s):  
Shahnaz Akhter ◽  
Md Rizwanul Karim
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Morbidity ◽  
Population Based ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
Multiparous Women

Introduction: Gestational diabetes mellitus (GDM) is a problem of growing interests both for the mother and the baby. Like other South East Asia countries the prevalence of GDM has also been progressively increasing in Bangladesh. Some population based studies conducted in Bangladesh have revealed an increasing trend of GDM prevalence ranging from 6% to 14% based in using different diagnostic criteria. Aim: To assess the fetal and maternal outcome in pregnancies complicated by gestational diabetes mellitus. Materials and Methods: This cross sectional study was conducted in Combined Military Hospital Dhaka from April 2018 to April 2019. Total 100 cases of GDM admitted in antenatal ward were taken into considerations. Maternal & fetal outcome was studied. Results: Study revealed that gestational diabetes was more common among >25 years old multiparous women. 88% GDM diagnosed at more than 20 weeks of gestation and more than 76% mothers with gestational diabetes delivered by caesarean section, 23% delivered vaginally. Pre-eclampsia were noted in 18% of patients. 25% babies were macrosomic at birth. 12% babies had hyperbillirubanaemia, 10% respiratory distress, 1% had congenital anomalies. Conclusion: Gestational diabetes mellitus is common with a rising prevalence and is associated with higher maternal and neonatal morbidity. It carries additional long term health consequences for the mother and her offspring. Diagnosis and appropriate treatment of the condition decreases morbidities for the mother & baby. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 18-21

scholarly journals Appropriate cesarean rates using Robson’s Ten-Group Classification System in a Brazilian private practice

2021 ◽  
Author(s):  
Andrea Silveira de Queiroz Campos
Keyword(s):  
Access To Health Care ◽  
Obstetric Care ◽  
Multidisciplinary Care ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Cesarean Sections ◽  
Cross Sectional ◽  
Childbirth Experience ◽  
Group 5 ◽  
Group 2

Abstract Background The increasing rates of cesarean sections (CS) in places with adequate access to health care is a global concern because they are related to higher rates of maternal and neonatal complications and do not provide a positive childbirth experience for women. The objective is to highlight the possibility of achieving CS rates acceptable by WHO standards, like Nordic countries, following evidence-based protocols in Brazil. Methods A cross-sectional study evaluated CS rates by Robson Groups for women who sought vaginal delivery in a private health practice in Brazil, comparing the rates with Swedish data. A collaborative practice with midwives and obstetrician, adopting evidence-based guidelines, was offered. The overall CS rate, CS rate by Robson group, contribution of each Robson group to the overall CS rate, clinical and non-clinical interventions and vaginal birth, pre-labor CS and intrapartum CS proportions were estimated. The expected CS rate for the population by the WHO c-model tool was calculated. The analysis used Microsoft EXCEL and the software "R Studio" (version 1.2.1335. 2009-2019). Results The overall CS rate was 15.1% (within the expected by the WHO c-model tool) in a population composed of 43.7% of women in Robson Group 1, 11.4% in Group 2 and 14.9% in Group 5, the greatest responsible for higher rates of CS, who altogether contributed to 75.4% of all cesarean sections. Conclusions Multidisciplinary care following evidence-based protocols, associated to a high motivation of both women and professionals of childbirth care for a vaginal route for delivery may lead to a significant and safe reduction of CS rates, obtaining better results even in contexts such as Brazil, where there is high medicalization of obstetric care and excess of CS.

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