A Cross Sectional Study of Robsons 10 Group Classification and its Impact on Caesarean Section Rate

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.

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A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170916 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1186

Author(s):

Dolly Chavda ◽

Kamal Goswam ◽

Kavita Dudhrejiya

Keyword(s):

Caesarean Section ◽

Caesarean Section Rate ◽

Fetal Distress ◽

Cross Sectional Study ◽

Obstetrics And Gynecology ◽

Sectional Study ◽

Lower Segment ◽

Cross Sectional ◽

Medical College ◽

Lower Segment Cesarean Section

Background: Though WHO recommends a rate of 10-15% caesarean section for a given hospital, there has been a rising trend worldwide. We estimated the recent incidence of caesarean section in Obstetrics and Gynecology Department, P.D.U. Medical College, Rajkot (Gujarat and correlated these rates with the socioeconomic, demographic, and health variables.Methods: We have studied 1000 cases of lower segment caesarean section (cross sectional study) at Obstetrics and Gynecology Department, P.D.U Medical College, Rajkot (Gujarat) to find out rate of caesarean section, common maternal and fetal indication and complications of lower segment caesarean section.Results: Caesarean section rate of the present study is 19.9%. Most common indication of LSCS was scarred uterus 39.9%.followed by fetal distress 19.1%, malpresentation 18.6%, and failed induction 7.3%. Maternal morbidities and mortalities in emergency LSCS in compare to elective LSCS. Analysis based on Robson’s ten-group showed that group 5 (Previous CS, single cephalic,>37 weeks) made the greatest contribution to total CS rate.Conclusions: Scientific advances, social and cultural changes, and medico legal considerations seem to be the main reasons for the increased acceptability of caesarean sections. The decision to perform a C-section delivery must be chosen carefully and should not be profit oriented. There is a possibility of keeping the rate to minimum by reducing number of primary caesarean sections, by proper counseling of the patients, proper monitoring and patience.

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Classification of births according to Robson 10 group classification: an emerging concept to audit the increasing caesarean section rate

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194354 ◽

2019 ◽

Vol 8 (10) ◽

pp. 3915

Author(s):

Priyanka Kolusu ◽

Palutla Himabindu

Keyword(s):

Caesarean Section ◽

Care Center ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Cross Sectional Study ◽

Group Classification ◽

Health Care Facilities ◽

Health Concern ◽

Cross Sectional ◽

Group 5

Background: High caesarean birth rates are an issue of international public health concern. Worries over such increases have led the WHO to advice that caesarean section rate should not be more than 15%. WHO proposes that the health care facilities to use the Robson’s 10 group classification system to audit their CS rates. Our aim was to investigate the CS rates in a period of 6 months using Robso’s 10 group classification.Methods: This was a cross sectional study conducted for a period of 6 months from July 2018 to December 2018 in Department of Obstetrics and Gynecology, Siddhartha medical college which is a tertiary care center .All women delivered during this period in labour ward were included. All relevant obstetric information (parity, mode of previous deliveries, previous CS and indications, gestational age, onset of labor) was entered on a questionnaire and classified into Robson’s 10 classes and percentages were calculated.Results: Total number of deliveries in 6 months is 4719 out of which C-sections are 1816 which accounts for 38.48%. Highest contribution was by group 5 and group 2. Together these two groups contribute to 62.4% of the total caesarean sections. Group 6 and group 9 by themselves did not contribute much but within their groups had 100% C-section rates.Conclusions: Robson’s 10 group classification provides easy way in collecting information about caesarean section rate which obtains good insight into certain birth groups. Number of women who attempt VBAC has declined over recent years due to fear of uterine rupture. Reducing primary C-section rates, adequate counseling and changing norms for non-reassuring fetal status could reduce contribution of Robson’s groups towards absolute C-section rates.

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Can the Robson 10 Group Classification System help identify which groups of women are driving the high caesarean section rate in major private hospitals in eastern Ethiopia? A cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-047206 ◽

2021 ◽

Vol 11 (8) ◽

pp. e047206

Author(s):

Shegaw Geze ◽

Abera Kenay Tura ◽

Sagni Girma Fage ◽

Thomas van den Akker

Keyword(s):

Caesarean Section ◽

Cross Sectional Study ◽

Group Classification ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Private Hospitals ◽

Spontaneous Labour ◽

Labour Group

ObjectiveThe rates of caesarean section (CS) in Ethiopian private hospitals are high compared with those in public facilities, and there are limited descriptions of groups of women contributing to these high rates. The objective of this study was to describe the groups contributing to increased CS rates using the Robson classification in two major private hospitals in eastern Ethiopia.DesignCross-sectional study.SettingTwo major private hospitals in eastern Ethiopia.ParticipantsAll women who gave birth from 9 January 2019 to 8 January 2020 in two major private hospitals in eastern Ethiopia.Primary and secondary outcome measuresThe primary outcome was the Robson 10 Group Classification System. The secondary outcome was indication for CS as recorded in the medical files.ResultsOf 1203 births in both hospitals combined during the study period, 415 (34.5%) were by CS. Women with a uterine scar due to previous CS (group 5), single cephalic term multiparous women in spontaneous labour (group 3) and single cephalic term nulliparous women in spontaneous labour (group 1) were the leading groups contributing 33%, 27.5% and 17.1%, respectively. The leading documented indications were fetal compromise (29.4%), previous CS (27.2%) and obstructed labour (12.3%).ConclusionMore than three-fourths of CS were performed among Robson groups 5, 3 and 1, indicating inadequate trial of labour after CS or management of labour among relatively low-risk groups (3 and 1). Improving management of spontaneous labour and strengthening clinical practice around safely providing the option of vaginal birth after CS practice are strategies required to reduce the high CS rates in these private facilities.

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A cross-sectional study on factors influencing caesarean section rates in a tertiary care hospital, Jhansi (Uttar Pradesh)

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213544 ◽

2021 ◽

Vol 8 (9) ◽

pp. 4404

Author(s):

Swati Singh ◽

Anil Kumar Malhotra

Keyword(s):

Caesarean Section ◽

Caesarean Delivery ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Cross Sectional Study ◽

Health Care Facilities ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Risk

Background: Worldwide rise in caesarean delivery (CD) rates during the last three decades has been a cause of alarm. The rates of such delivery have increased dramatically in recent years from 12% in 1990 to 24% in 2008. Tertiary care centers have high caesarean section rates but areas where health care facilities are not available may have maternal deaths due to lack of C-section facilities. The present study was conducted to determine the prevalence of caesarean section, to assess the association between caesarean section with socio-demographic determinants and maternal risk factors.Methods: Cross-sectional study was conducted during January 2016 to April 2016. A total of 288 pregnant females admitted in obstetric ward of medical college Jhansi formed the study population, a simple random sampling technique was adopted for the study. A study tool was pre-designed and pre-tested interview schedule. The data collected was entered in MS excel and analyzed using SPSS 24 version.Results: The study showed that 73 (25.34%) of our study participants have delivered by caesarean section. Caesarean section was significantly associated with literacy, place of residence, education status, socio-economic status and occupation of the husband. Caesarean section was significantly associated with maternal risk factors like obesity, pregnancy induced hypertension, gestational diabetes mellitus and polyhydromnios.Conclusions: Present study found a high caesarean section rate as compared to the WHO standard. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery.

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An audit of caesarean section rate based on Robson’s ten group classification system

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202712 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2803

Author(s):

Jishma Jose ◽

Sendhil Coumary Arumugam ◽

Syed Habeebullah

Keyword(s):

Caesarean Section ◽

Classification System ◽

Caesarean Section Rate ◽

Fetal Distress ◽

Cross Sectional Study ◽

Group Classification ◽

Health Concern ◽

Initial Structure ◽

Cross Sectional ◽

Group 5

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.

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Use of the Robson classification to assess caesarean section trends in tertiary hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181905 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1796

Author(s):

Gomathy Gomathy E. ◽

Kondareddy Radhika ◽

Triveni Kondareddy

Keyword(s):

Caesarean Section ◽

Caesarean Section Rate ◽

Tertiary Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Group Classification ◽

Health Care Facilities ◽

Care Hospital ◽

Cross Sectional ◽

Robson Classification

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 6 months at a tertiary care hospital in a rural area in Karnataka, 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 50.3% of the total Caesareans. Followed by Group 1 and 10. A Groups 6, 4, 8 and 9 by themselves did not contribute much but within their groups had a 100% C-section rate.Conclusions: Robson 10-group classification provides easy way in collecting information about Caesarean section rate which obtains good insight into certain birth groups. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for 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.

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Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

Heliyon ◽

10.1016/j.heliyon.2021.e07755 ◽

2021 ◽

pp. e07755

Author(s):

Victoria Bam ◽

Alberta Yemotsoo Lomotey ◽

Abigail Kusi-Amponsah Diji ◽

Hayford Isaac Budu ◽

Dorothy Bamfo-Ennin ◽

...

Keyword(s):

Decision Making ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Influencing

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FAILED SPINAL ANESTHESIA

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.12.1811 ◽

2016 ◽

Vol 23 (12) ◽

pp. 1527-1530

Author(s):

Mobeen Ikram ◽

Abdul Samee ◽

Muhammad Amir ◽

Muhammad Imdad

Keyword(s):

Pain Management ◽

Caesarean Section ◽

Spinal Anesthesia ◽

Teaching Hospital ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Emergency Caesarean ◽

Indirect Supervision ◽

Study Setting

Objectives: To determine the frequency of failed spinal anesthesia in patientsundergoing caesarean section in a teaching hospital in Pakistan. Study Design: It was a cross– sectional study. Setting: Department of Anesthesia and Pain Management PAF HospitalSargodha. Period: January 2015 to May 2015. Methodology: A total of 293 pregnant patientsundergoing caesarean section under spinal anesthesia were included. After prehydration andessential monitoring, all patients were given spinal anesthesia with 25 G spinal needle at L3-L4 or L4-L5 level by 2nd year resident anesthesiologist under indirect supervision using 1.5 mlof hyperbaric spinal injection. Failure to achieve adequate block was managed by differentmodalities like sedation, analgesia with ketamine, repeat spinal anesthesia or to proceed withgeneral anesthesia. Results: Out of total of 293 patients, failed spinal occurred in 9 patients(3.07%). Out of these 9 patients, 02 patients (22.22%) were elective caesarean sections while07 cases (77.77%) were emergency caesarean sections. Conclusion: The chances of failedspinal anesthesia are more in emergency caesarean sections as compared to elective casesand failure rate of spinal anesthesia in PAF teaching hospital Sargodha is 3.07% which is slightlyhigher than 3%

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Caesarean section at Koudougou regional hospital centre: indications and prognosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205211 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4792

Author(s):

Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽

Lankaonde Martin ◽

Savadogo-Komboigo B. Eveline ◽

S. I. B. Sansan Rodrigue ◽

Ouedraogo Wendlassida Estelle ◽

...

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Caesarean Section Rate ◽

Cross Sectional Study ◽

Cross Sectional ◽

Important Place ◽

History Of ◽

Group 3 ◽

Group 5 ◽

Uterine Scar

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.

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