Audit of caesarian deliveries in a tertiary care center, in rural Bangalore, India

Background: 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 rural tertiary care teaching hospital in Bangalore, using Robson’s ten groups classification.Methods: This study was done in MVJ Medical College and Research Hospital, a rural tertiary care teaching hospital. All patients who underwent caesarean delivery, between November 2017 and October 2018, were included in the study. Women were classified in 10 groups according to Robson’s classification. For each group, authors calculated its relative contribution to the overall caesarean rate.Results: The overall caesarean section rate was 46.7%. The main contributors to this high caesarean rate were primiparous women in spontaneous labour (group 1) and women with previous caesarean section (group 5). 52.1% of CS were conducted on women who were unbooked or booked at a peripheral health facility and referred to present institution due to complications in labor. Strategies to lower CS rates would include encouraging women with previous CS, to undergo trial of labor to reduce CS rates for group 5C. Sensitization of staff in peripheral medical facilities for early referral of high-risk pregnancies to a tertiary care center for better control of medical complications like hypertensive disorders of diabetes mellitus. Other strategies include offering external cephalic version to eligible women with breech presentation and consider offering vaginal breech delivery to suitable women in groups 6 and 7.Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.

Download Full-text

Antepartum hemorrhage at a tertiary care teaching hospital in Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v4i2.24585 ◽

2017 ◽

Vol 4 (2) ◽

pp. 44-48

Author(s):

Sarada Duwal Shrestha ◽

Reena Shrestha ◽

Alka Singh ◽

Praban Sharma ◽

Anagha Malla Pradhan ◽

...

Keyword(s):

Caesarean Section ◽

Blood Transfusion ◽

Teaching Hospital ◽

Postpartum Hemorrhage ◽

Placenta Previa ◽

Tertiary Care ◽

Hypovolemic Shock ◽

Perinatal Morbidity ◽

Tertiary Care Teaching Hospital ◽

Care Teaching

Introductions: Antepartum hemorrhage (APH) is a serious obstetrical emergency and is a leading cause of maternal and perinatal morbidity and mortality. Incidence varies from 2-5% of all deliveries. The maternal and perinatal complications of APH are anemia, postpartum hemorrhage, shock, low birth weight, intrauterine fetal death and birth asphyxia. Methods: This descriptive study was conducted at Department of Obstetrics and Gynaecology of Patan Hospital, a tertiary care teaching hospital of Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. All patients who were admitted after 22 weeks of gestation with diagnosis of antepartum hemorrhage from April 2012 to April 2016 were included. Results: The incidence of APH was 0.23% in the present study. Out of 84 patients, 39.3% were in age group of 25-29 years, 63% were multigravidae, 63% had placenta previa, 92.3% lower segment caesarean section done in new onset APH and 53.1% done in previous admitted cases of APH, 23.8% developed hypovolemic shock, 14.3% needed blood transfusion, 9.5% had postpartum hemorrhage, 1.2% had caesarean hysterectomy, 54.8% had preterm delivery, 9.5% were admitted in neonatal intensive care unit and perinatal mortality was 10.7%. Conclusions: APH is a major cause of maternal and perinatal morbidity and mortality. In our study, the most common cause of APH was placenta previa. The commonest mode of delivery was caesarean section. The major maternal complication was hypovolemic shock with consequent high blood transfusion rate and fetal complication in prematurity.

Download Full-text

Analysis of indication of caesarean sections according to Robson’s ten group classification system at a tertiary care teaching hospital in South Rajasthan

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210743 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1106

Author(s):

Saroj Saharan ◽

Radha Rastogi ◽

Deepti Chyaunal

Keyword(s):

Teaching Hospital ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Group Classification ◽

Obstetrics And Gynecology ◽

Tertiary Care Teaching Hospital ◽

Care Teaching ◽

Medical College ◽

Group 5 ◽

Group 2

Background: The objective of this study was categorization and evaluation of the caesarean section rate at our institute as per Robson’s formula.Methods: This retrospective study was conducted at department of obstetrics and gynecology, RNT Medical college, Udaipur, a tertiary care teaching hospital in South Rajasthan. The data was collected retrospectively from December 2020 to February 2020 over a period of 2 months and percentage were calculated in various groups as per Robson’s ten group classification system.Results: Among a total of 1195 women delivered during study period, 420 (35.14%) delivered by CS. Women with previous CS (group 5) contributed maximum (35.95%) to the total number of CS followed by group 2 (27.14%).Conclusions: Standardization of indication of caesarean deliveries, regular audits and definite protocol in hospitals will aid in curbing the rate of caesarean deliveries in hospitals.

Download Full-text