scholarly journals A retrospective study to analyse the rate of caesarean section according to Robson's 10 group classification in a peripheral hospital in a metropolitan city

Author(s):  
Siddhi S. Kore ◽  
Fatema Shams ◽  
Jayanth Chilkund ◽  
Gauri Kore

Background: In the past several decades, a pattern of rapid increases in Caesarean section (CS) delivery rates has been observed worldwide, as also in India. It is important to identify the reason behind the rising rates of CS since they can pose unnecessary risks to the mother and the neonate. The aim of the study was to analyse the CS rate in the ten groups as per Robson’s ten group classification, in a peripheral hospital in a metropolitan city. By this study we have tried to identify specific groups of women to be targeted to reduce CS rates.Methods: This is a retrospective study carried out at a peripheral hospital in Mumbai, India. It included all women who had delivered in the hospital from January, 2019 to December, 2019. The sample size was 2603.Results: Under this study, we found out that the rate of CS delivery is higher than what is recommended by WHO in Robson’s group 2, 5 and 6.Conclusions: This study will help us carry out targeted interventions so as to reduce the CS rates in these groups.

10.12737/6453 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Бадаева ◽  
A. Badaeva

Objectives. To study the trend of Caesarean section (CS) rate increase in the Tula region. Methods. A multicenter retrospective study of labor and delivery reports of women in Tula region, Russia who had CS procedures between the years 2000 and 2010. Robson’s Ten-Group Classification System (10-group classification) provides a clinically relevant classification of CS rates that provides a useful basis for internation-al comparisons and trend analyses. Results. In Tula region the total number of deliveries increased by 26.6% from the year 2000 as compared to 2010, the CS rate increased from 17.1 to 27.7%. The increase in CS deliveries was mostly attributed to three characteristic groups: multiparous women with uterine cicatrix; primaparous women who had medical conditions for a planned CS and these, who had labor induction; women with a gestational age less than 37 weeks. The largest Robson group was nulliparous women in spontaneous labor. Conclusions. Future efforts to reduce the overall CS rate should be focussed on reducing the primary CS rate.


Author(s):  
Hiralal Konar ◽  
Madhutandra Sarkar ◽  
Sisir Kumar Chowdhury

Introduction: The Robson ten-group classification identifies the women’s groups that make the greatest contribution to the overall rate of Caesarean Section (CS), and thereby helps to optimise CS rates. It also helps to ensure optimum maternal and perinatal outcomes. Aim: This study was undertaken to examine the rates of CS using the Robson ten-group classification, and also to identify the women’s groups that contribute most to CS rates in a tertiary care teaching and referral hospital in Kolkata, India. Materials and Methods: This cross-sectional observational study was conducted over a period of one year from May 2012 to April 2013. All pregnant women admitted under the supervision of a particular unit of the Department of Obstetrics and Gynaecology and delivered in that hospital during the study period were included. Necessary data collection was done on the following parameters, i.e., previous obstetric history, category of pregnancy, course of labour and delivery, and gestational age. The women were categorised into the ten Robson groups. For each group, the CS rate, relative size of the group, and the percentage contribution made by the group to the overall CS rate were calculated and expressed in percentages. Chi-square test, Z-test and the trial version of Statistical Package for Social Sciences (SPSS) version 20.0 were used to analyse the data. Results: The CS rate in the present study was 43.13% (735 out of 1704 deliveries). Not only the largest group in terms of relative size 649 (38.08%), the Robson group 1 had a CS rate of 41.75% (271/649), as well as the largest absolute number of caesarean deliveries. The group 1 made the largest contribution (271) to the overall CS rate (15.9%). The group 5 was the second largest contributing group 155 (9.09%), followed by group 3 96 (5.63%) and group 2 69 (4.04%). In the present study group 5 showed the CS rate of 95.67%, group 3 with CS rate of 24.48% and group 2 with CS rate of 60.52%. Conclusion: The Robson groups 1, 2, 3 and 5 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Active management of labour in a primigravida with spontaneous onset, reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be few effective strategies.


Author(s):  
Spandana S. ◽  
Amarpali K. Shivanna

Background: Caesarean section rates have been increasing worldwide. For proper assessment, the ten group Robson classification is recommended by WHO for assessing CS rates. We are analyzing the caesarean section rates by classifying the caesarean sections using modified Robson’s ten group classification. Objective of the current study was to estimate caesarean section rates in our hospital and to classify caesarean section using modified Robson’s ten group classification system.Methods: Current retrospective study was conducted in the department of obstetrics and gynaecology in a tertiary care hospital. The medical records were reviewed for a period of 12 months.Results: Total number of deliveries during the study period was 315. The total numbers of caesarean section were 159 and total vaginal deliveries were 156. The caesarean section rate was 50.47%. The main contributors to overall caesarean section rate were group 5 (18.10%), group 2 (13.96%) and group 1 (5.71%). Women with one previous LSCS contributed majorly to the caesarean section rate. Higher CS rate was also seen in both group 2A (69.40%) and group 4A (47.30%) which had underwent induction of labour. More inclination towards trial of labour following CS for women with previous one LSCS can lower CS rates.Conclusions: Modified Robson’s classification is easily implementable and an effective tool for ongoing surveillance. The results can be compared between Institutions, states and countries. Having implemented the Robson classification and identified groups which contributed the most to the overall CS rate, interventions to reduce the same has to be our prime objective.


Author(s):  
Shery Angel Rajakumar ◽  
Sindhura Myneni ◽  
Kamala Roshini M.

Background: Rising caesarean section (CS) rates are a major public health concern worldwide. The main objective of our study was to analyse the CS rates according to Robson ten group classification system (TGCS).Methods: This was a retrospective study conducted in the department of obstetrics and gynaecology at Chettinad hospital and research institute, during a period of 5 years from May 2015 to April 2020. All the women who delivered by CS were included in the study. The data regarding parity, gestational age, onset of labour, number of foetuses and presentation was collected and classified according to Robson TGCS and analysed.Results: A total of 4199 women delivered during the study period. Out of 4199 women 2149 (51.18%) underwent CS. All the women who underwent caesarean section were classified according to Robson TGCS. Group 5 contributed the most (40.81%). Group 2 had the second highest contribution of 33.36%. Group 1 had 6.24%, group 3 and 4 contributed for 1.16% and 4.65% respectively. Group 6 and 7 had 2.84% and 1.68% respectively. Group 8 had 2.28%, group 9 had 0.23% and group 10 constituted 6.75%.Conclusion: As contribution of repeat CS is high among the overall CS rate it is important to reduce the primary CS rates. More analytical studies need to be done based on Robson TGCS to evaluate the indication of CS within each group.


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):  
Sowmya Koteshwara ◽  
Sujatha M. S.

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. 


Author(s):  
Deepika Jamwal ◽  
Pallavi Sharma ◽  
Anil Mehta ◽  
Jiteshwar Singh Pannu

Background: There has been an increase in rate of caesarean section over last five decades. This is a matter of international public health concern as it increases the caesarean section related maternal morbidity. The aim of the present study was to evaluate that in a new medical college which clinical situation contributed and led to caesarean deliveries as per Robson’s classification system and to audit the increasing rate of caesarean section.Methods: This study was performed in Government Medical College Kathua in the Union territory of Jammu and Kashmir from November 2020 to April 2021. In the present study, all cases delivered by caesarean section during the period of six months were recorded and classified according to Robson's 10 group classification system.Results: Out of total 1366 women delivered, 630 underwent CS (46.12%). It was observed that majority of caesarean sections belonged to group 2 and group 5 of Robson criteria. Group 5 comprised of patients with one or more previous caesarean section with cephalic presentation according to Robson criteria and maximum number of caesarean sections done in the present study belonged to this group that is 40.3%. Group 2 that is nulliparous singleton cephalic >37 week induced labour or caesarean section before labour comprised 29.2%. Breech pregnancies (groups 6 and 7) had >90% caesarean rates.Conclusions: Women with a previous caesarean delivery represent an increasing proportion of caesarean deliveries. Use of the Robson criteria allows standardized comparisons of data and identifies clinical scenarios driving changes in caesarean rates. Hospitals and health organizations can use the Robson 10-Group Classification System to evaluate quality and processes associated with caesarean delivery.


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):  
Priya Shankar ◽  
Madhu J. ◽  
Vinay Raju

Background: Auditing c section rates can be done using Robson’s classification which in turn helps achieve a uniform basis for comparison across centers and across various countries.Methods: A retrospective analysis was done in a tertiary care hospital in north Karnataka KIMS, over a period of 6 months May 2017 to October 2017. All cases of LSCS done during this period were classified according to Robson’s classification and analyzed.Results: Out of 5080 overall deliveries 1876 delivered by cesarean section attributing to 36.76% cesarean section rate. Highest contribution was from group 5 (36%) and group 2 (19.24%).Conclusions: Robson’s classification helps to identify and analyze the group that contribute to the most to overall cesarean section rate and this helps us to modify strategies and interventions to optimize cesarean section rate.


Author(s):  
Ruchi Gupta

Background: In view of upsurging Caesarean section (CS) rate worldwide WHO conducted two multicountry surveys to diagnose the driving determinants. In two WHO surveys increased overall CS rate was observed from 26.4% to 31.2% worldwide except Japan. Both WHO 2014 and FIGO 2016 recommend Robson ten- group classification for monitoring caesarean rate over time because of its clarity, tenacity, resilience and pliability. Our Aim is to classify women delivered in our Hospital as per Robson ten –group classification and access the factor driving caesarean rate in each group.Methods: This is a retrospective study 1671 caesarean section conducted in tertiary hospital over 6 months (July- December) 2018. All the delivering women were classified according to Robson ten-group classification and data was analyzed using Microsoft excel and SPSS 23 software.Results: During the study period there were 5917 deliveries. Of these 1671 deliveries were CS accounting for CS rate of 28.24% . The major contributor to CS rate were women in group 5 followed by primigravida’s in group 1 and 2. Increasing  CS rate was observed in group 1 ,2, 3 and 5. Most common indication for caesarean section was fetal distress , failed induction , previous caesarean , breech and Antepartum hemorrhage.Conclusions: Increasing trend in CS rate is observed in group 1,2 ,3 and 5. In order to reduce CS rate among group 2 better patient selection is required for induction of labour based on Bishop score. In order to reduce CS rate in group 5 promotion of  VBAC deliveries should be encouraged. By classifying women according to Robson group 10 classification  helps in identification of women likely to deliver by caesarean  and to identify effective strategies to optimize the CS rate.


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