scholarly journals Analysis of Cesarean Section at a Tertiary care centre in Eastern Nepal according to Robson's Ten Group classification System (TGCS): A hospital based cross sectional study.

2020 ◽  
Vol 5 (3) ◽  
pp. 1171-1175
Author(s):  
Anamika Das ◽  
Ajay Agrawal ◽  
Sangeeta Bhandari ◽  
Sanyukta Rajbhandari ◽  
Surya Prasad Rimal
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Care ◽  
Relative Size ◽  
Group Classification ◽  
Health Care Facilities ◽  
Cesarean Section Rate ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
The Absolute

Introduction: Cesarean sectionis on the rising trend,so WHO proposes that health care facilities uses the Robson's 10 group classification system to audit their Cesarean section rates. This classification will helpto developstrategies to reduce these rates. Objective: The objective of this study was to classify the women coming for delivery into the 10 Robson’s group,to interpret the 10 group classification and to know the highest rate of cesarean section in the group. Methodology: This was a hospital basedcross sectional study carried out in the Department of Obstetrics and Gynaecology, for a period of 6months. All women undergoing deliverywere recruited for study .Based onthe  patient’s obstetric parameters, women were assigned to one of 10 groups as per Robson’s 10-group classification system.The relative size of each group, the cesarean section rate in each group, and the absolute and relative contributions to the overall cesarean section rate was then reported. Results: During the study period, the overall Cesarean Section rate was 33.40%.Highest contribution was by Robson's Group 2(Nulliparous, single cephalic, ≥ 37 weeks, induced or CS before labor(9.84%) followed by Group 1(Nulliparous, single cephalic, ≥ 37 weeks, in spontaneous labor)(7.73%) and Group 5(Previous CS, single cephalic, ≥ 37 weeks)  (5.75%). Least contribution was by Groups 8(All multiple pregnancies (including previous CS)and 9[All abnormal lies (including previous CS)]0.20% and 0.27% respectively. All women in group 9(all abnormal lies including previous CS)had 100% Cesarean rate. Conclusions: With reductions in the primary cesarean section rates and encouragingpatients forVBACcould reduce the contribution of Robson's groups towards the absolute Cesarean Section rates.

scholarly journals Analysis of Cesarean Section Rate using Robson's Ten Group Classification System and comparing the Trend at a Tertiary Hospital for 2 Years

2016 ◽  
Vol 8 (3) ◽  
pp. 175-180
Author(s):  
RC Prameela ◽  
Gatta Shilpa ◽  
Asma Farha ◽  
S Prajwal
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Relative Size ◽  
Tertiary Hospital ◽  
Group Classification ◽  
Cesarean Section Rate ◽  
Group Iii ◽  
Group I ◽  
Labor Ward ◽  
Operative Notes

ABSTRACT Aims and objectives To classify the cesarean section (CS) in different groups of Robson's ten-group classification system (TGCS) and comparing the rate and relative size of groups with that of previous year at the tertiary hospital. Materials and methods This retrospective study was conducted in Cheluvamba Hospital, which is a tertiary hospital attached to Mysore Medical College & Research Institute, Mysuru, between January 1, 2014 and December 31, 2014. The data collected was compared with the previous year data between January 1, 2013 and December 31, 2013. The data collected included parity, mode of previous delivery, gestational age, onset of labor-spontaneous or induced, delivery notes of labor ward, and operative notes of CS. This data was then applied to the Robson's TGCS for the year 2014 and compared with that of 2013. Results The total deliveries during 2014 were 12,930 and in 2013 were 15,182. The number of CSs during 2014 was 3,793 and in 2013 it was 3,917. Cesarean section rate in 2014 was 29.33% while in 2013 it was 25.8%. The CS rate has come down to half in group I (nulliparous, single, cephalic. 37 weeks, in spontaneous labor) and to onefourth in group III [multiparous (excluding previous CS) single, cephalic. 37 weeks, in spontaneous labor] in 2014. Conclusion Robson's TGCS is easy to classify. Clinical significance The study showed reduction in CS rate by half in group I and by one-third in group III in 2014 in our institution. This was probably due to the increased awareness among the staff of the institute by the previous year study about higher CS rate. How to cite this article Prameela RC, Shilpa G, Farha A, Prajwal S. Analysis of Cesarean Section Rate using Robson's Ten Group Classification System and comparing the Trend at a Tertiary Hospital for 2 Years. J South Asian Feder Obst Gynae 2016;8(3):175-180.

scholarly journals A study of cesarean section rate by using modified Robson's ten group classification system

2019 ◽  
Vol 8 (7) ◽  
pp. 2610
Author(s):  
Meha K. Patel ◽  
Saloni M. Prajapati
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Tertiary Care Centre ◽  
Maternal Characteristics ◽  
Spontaneous Labour ◽  
Group 5

Background: High caesarean section rate worldwide including India is matter of concern. 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 tertiary care centre according to Modified Robson’s ten groups classification.Methods: This retrospective study was conducted at GMERS Gotri Medical College, Vadodara, Gujarat, India. All patients who delivered between August 2018 and March 2019, were included in the study. Women were classified in 10 groups according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caesarean rate.Results: Total number of delivery in my study institute in 8 months was 1531 out of them 456 was cesarean section, so the overall caesarean section rate was 29.78%. The main contributions to overall caesarean rate was 40.78% by group 5 (previous CS, singleton, cephalic, >37weeks) followed by 14.25% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 11.40% by group 2 (nullipara, singleton, cephalic,>37 weeks, induced or CS before labour). CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 98.4% in previous CS (group 5), 84% in nulliparous breech (group 6), 58% in multiparous breech (group 7) and least 8.2% in multipara spontaneous labour (group 3).Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.

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 Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 839-843
Author(s):  
Renuka Tamrakar ◽  
Sachin Sapkota ◽  
Deekshanta Sitaula ◽  
Rohit Thapa ◽  
Bandana Pokharel ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cesarean Deliveries

Introduction: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. Conclusions: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.

scholarly journals Use of a Classification Tool to Determine Groups of Women That Contribute to the Cesarean Section Rate: Establishing a Baseline for Clinical Decision Making and Quality Improvement

2012 ◽  
Vol 2 (2) ◽  
pp. 85-95 ◽  
Author(s):  
Valerie Slavin ◽  
Jennifer Fenwick
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Clinical Decision Making ◽  
Breech Presentation ◽  
Clinical Decision ◽  
Models Of Care ◽  
Group Classification ◽  
External Cephalic Version ◽  
Cesarean Section Rate ◽  
Classification Tool

OBJECTIVE:To identify the groups of women who are the largest contributors to the cesarean section rate at a maternity facility in South East Queensland, Australia. Examining the characteristics of these women will allow the development of unit-focused initiatives aimed at reducing cesarean sections in these groups of women.METHOD:A modified version of the Robson Ten Group Classification System was identified as the most appropriate tool to determine cesarean section rates in different groups of women. A prospective clinical audit was then carried out during a 6-month period in 2010 using the tool.FINDINGS:The Robson Ten Group Classification System identified that planned repeat cesarean section was the largest contributor to the cesarean rate. This was followed by women having their first baby, women having an induction, and women who have a breech presentation at term.CONCLUSIONS AND IMPLICATIONS:The Robson classification tool was useful in identifying groups of women at risk of a cesarean section. Unit-specific strategies can now be developed and implemented in an effort to lower the rate. These include increasing the vaginal birth after cesarean rate, the uptake of external cephalic version, supporting nonintervention birth environments, and implementing models of care where clinicians are skilled in facilitating normal birth. The value of using such a tool is the ability to monitor change over time as well as facilitating the comparison of data between units of a similar nature.

scholarly journals Auditing the cesarean section rate by Robson’s ten group classification system at Tertiary Care Hospital.

2020 ◽  
Vol 27 (04) ◽  
pp. 700-706
Author(s):  
Mehak Asim Khan ◽  
Irum Sohail ◽  
Maria Habib
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Care ◽  
Population Based ◽  
Group Classification ◽  
Care Hospital ◽  
Cross Sectional ◽  
Lower Segment Cesarean Section ◽  
Gynecology And Obstetrics ◽  
Group 5

Objectives: To analyze the trends of cesarean sections, categorize them into Robson’s Ten Group Classification System (RTGCS), to identify the groups contributing the most to overall lower segment cesarean section (LSCS) rate and to formulate strategies for reducing these rates. Study Design: Cross sectional population based study. Setting: Gynecology and Obstetrics Department of Kahuta Research Laboratories (KRL) hospital, Islamabad. Period: From 1st Nov, 2017 to 30th April, 2018. Material & Methods: The births during this period were distributed into the RTGCS on the basis of past obstetric history and fetal characteristics along with mode of onset of labour. Overall LSCS rate was calculated and contribution of each group was analyzed separately by SPSS version 23. Results: Our study showed 617 LSCS out of 964 deliveries making a high LSCS rate of 64%. Group 5, 2 and 10 of RTGCS contributed to the majority of LSCS performed with the percentages of 47.5%, 18.5% and 12.8% respectively. Group 5 of RTGCS which contributed to the highest LSCS rate had 354 subjects which were previous scars out of which 199 had previous 1 scar making the percentage 56.21%. It contributed 32.3% to the overall LSCS rate. Conclusion: RTGCS is a very useful tool for auditing the LSCS rate at local, national and international levels. Once the LSCS are classified into specific RTGCS, analysis can be done about the reasons for the increasing rates of LSCS and then strategies can be devised to reduce them.

scholarly journals Retrospective study of cesarean section by using the Robson’s ten group classification system

2018 ◽  
Vol 7 (3) ◽  
pp. 1054
Author(s):  
Manoj Bhatt ◽  
Gunvant Kadikar ◽  
Dipti C. Parmar ◽  
Medha Kanani
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Group Classification ◽  
Cesarean Section Rate ◽  
Vaginal Birth After Cesarean ◽  
Relative Contribution ◽  
Study Institute ◽  
Group 5 ◽  
Previous Cesarean ◽  
Group 1

Background: The present study was done to determine the relative contribution of each of ten groups of robson´s classification to overall cesarean section rate and identify modifiable group for intervention to reduce the cesarean rate.Methods: Retrospective review of record of cesarean section from the statistical Dept of Obstetrics and Gynecology sir T. hospital, Bhavnagar from January 2017 to October 2017 and classify them in to Robson´s ten group classification system to find out total number of cesarean among total number of delivery in above 10 months duration.Results: Total number of delivery in my study institute in 10 months was 3804 out of them 1182 was cesarean section, so the overall cesarean section rate in Sir T. hospital, Bhavnagar was 31%. Group 1 (Nulliparous, single cephalic, >37 weeks in spontaneous labor), 2 (Nulliparous, single cephalic, >37 weeks, induced or CS before labor) and 5 (Previous CS, single cephalic, >37 weeks) contributes for around 66% of total cesarean. Group 5 (Previous CS, single cephalic, >37 weeks) was the major contributor among all. Least common cause of cesarean was group 8 (All multiple pregnancies (including previous CS)) and group 9 (All abnormal lies including previous CS).Conclusions: Incidence of cesarean was more common with patient having previous cesarean section. So, to decrease cesarean rate trial of labour should be given to the patient who was suitable for vaginal birth after cesarean section. Adequate assessment of pelvis and giving trial to patient having borderline pelvis also decrease the rate of cesarean in primi gravid (group 1).

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