scholarly journals Analysis of Cesarean Section Using Robson’s 10-Group Classification at a Tertiary Level Hospital in Nepal

2018 ◽  
Vol 17 (2) ◽  
pp. 4-11
Author(s):  
Rosy Vaidya Malla ◽  
Chanda Hamal ◽  
Bibhusan Neupane ◽  
Ratna Khatri
Keyword(s):  
Breech Presentation ◽  
Fetal Distress ◽  
Group Classification ◽  
Close Monitoring ◽  
Multiparous Women ◽  
Obstetric Services ◽  
Group 3 ◽  
Group 5 ◽  
Level Hospital ◽  
Group 1

Introduction: Obstetric Services commenced at the teaching institute where this study was conducted from Aug 2012. Hence, a review of the data of C-section in this hospital is needed for standardisation of the obstetric services in terms of the rate of C-section, its various clinical indications and maternal and fetal outcomes.Methods: This is a retrospective study carried out over a period of 5 years from Aug 13, 2012 to Aug 11, 2017. All hospital deliveries conducted during the study period were included in this study and the patients’ details obtained from hospital records. All data obtained was recorded in master charts and analysed using SPSS version 23. The caesarean rate, its indications were calculated and categorised into groups according to Robson’s 10-group classification. Results: A total number of 4892 deliveries were conducted over this 5-year study period. C-section was performed in 1104 patients, giving a C-section rate of 22.57%. The most common indications were previous C-section (25.4%), fetal distress (14.3%) and breech presentation (10.3%). Robson’s Group 1 was the highest contributors to the overall CS rate, contributing 28% of all C-sections, followed by Group 5 (26.8%) and Group 3 (15.5%).Conclusions: Nulliparous and multiparous women in term pregnancy in labor and women with previous C-section contribute to more than 70% of overall C-sections at our centre. Hence, close monitoring of these groups of patients, increasing the use of instrumental delivery and practice of vaginal birth after C-section can significantly reduce the C-section rate in our centre. 

scholarly journals Analysis of Caesarean Section Rates Using the Robson Ten-group Classification at a Tertiary Care Teaching Hospital in Eastern India: A Cross-sectional Study

2021 ◽  
Author(s):  
Hiralal Konar ◽  
Madhutandra Sarkar ◽  
Sisir Kumar Chowdhury
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Relative Size ◽  
Group Classification ◽  
Cross Sectional ◽  
Care Teaching ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

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.

scholarly journals Rising trends of caesarean section in modern obstetrics: analysis by Robson classification

2020 ◽  
Vol 9 (11) ◽  
pp. 4468
Author(s):  
Shery Angel Rajakumar ◽  
Sindhura Myneni ◽  
Kamala Roshini M.
Keyword(s):  
Caesarean Section ◽  
Group Classification ◽  
Health Concern ◽  
Public Health Concern ◽  
Robson Classification ◽  
Obstetrics And Gynaecology ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

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.

scholarly journals Caesarean section audit in a tertiary hospital of North India using Robson’s classification

2019 ◽  
Vol 8 (4) ◽  
pp. 1426
Author(s):  
Ruchi Gupta
Keyword(s):  
Caesarean Section ◽  
Fetal Distress ◽  
Tertiary Hospital ◽  
Group Classification ◽  
North India ◽  
Effective Strategies ◽  
Group 5 ◽  
Group 2 ◽  
Failed Induction ◽  
Group 1

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.

Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

scholarly journals Morphological Characterization of Isolates of Phomopsis vexans of Bangladesh

2013 ◽  
Vol 8 (1-2) ◽  
pp. 123-130
Author(s):  
MM Islam ◽  
M Asaduzzaman ◽  
ME Hoque ◽  
MB Meah
Keyword(s):  
Morphological Characterization ◽  
Cultural Properties ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Phomopsis Vexans ◽  
Group 1

Forty four isolates of Phomopsis vexans from different eggplant cultivars collected from core eggplant growing regions of Bangladesh which were characterized using mycological characteristics. Variation exists among the isolates of Phomopsis vexans of Bangladesh covering two types of farm having two ecosystems and the isolates were grouped into five distinct groups based on their cultural properties. The highest sized ? conidia were observed in group -1 and the lowest size in-group -2. The highest sized ? conidia were recorded in group -5 and the lowest in-group –2. The highest pycnidial size noted in-group -3 and the smallest sized pycnidia were recorded in group –1. DOI: http://dx.doi.org/10.3329/jsf.v8i1-2.14635 J. Sci. Foundation, 8(1&2): 123-130, June-December 2010

Timing of melatonin treatment: differential effects on oestrus and coat growth in goats

1997 ◽  
Vol 65 (2) ◽  
pp. 267-273 ◽  
Author(s):  
I. A. Forsyth ◽  
F. E. Gebbie ◽  
J. Arendt
Keyword(s):  
Goat Milk ◽  
Normal Weight ◽  
Ovarian Activity ◽  
Plasma Prolactin ◽  
Dairy Goats ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

AbstractTo avoid winter scarcity of fresh goat milk, simple methods of advancing the season of kidding would be commercially valuable. A combination of long-day light treatment followed by melatonin is successful but other aspects of seasonality including coat growth are also reset. To investigate whether effects on breeding season and coat growth can be dissociated, British Saanen dairy goats (no. = 30) were randomly allocated to one of six groups. Control goats were untreated. Goats in the other five groups received 2 months of treatment with 20 h light: 4 h darkness (20L: 4D) and were then given 3 mg melatonin orally at 16.00 hfor 2 months. The treatments started on 11 January (group 1), 29 March (group 2), 14 June (group 3), 30 August (group 4) and 8 November (group 5). Weekly blood samples were taken for the measurement of progesterone to monitor ovarian activity and prolactin. Side patches (10 cm ×10 cm) were clipped monthly from alternate sides and weighed to measure coat growth. The onset of ovarian activity was advanced from a median date of 15 November in controls to 24 May in group 1 (P < 0·01), 16 August in group 2 (P < 0·05) and 18 October in group 3 (? < 0·05). Groups 4 and 5 showed no significant change in the onset of oestrus (median onset dates 8 November and 1 November, respectively). Group 1 goats came into season again with controls in November. In all except group 5, treatment interacted with time to affect significantly the growth of the coat. The pattern of coat growth was most altered (P < 0·001) in groups 1 and 2. This was associated with effects on plasma prolactin concentrations of light stimulation and melatonin suppression. Group 1 goats resynchronized with control goats to show a coat of normal weight in the winter following treatment. Division of milking goat herds into spring and autumn kidding groups is, therefore, a practical possibility, but effects on overall milk yield require study.

THE EFFECTS OF SLAUGHTER WEIGHT AND SEX ON THE COOKING LOSSES FROM AND PALATABILITY ATTRIBUTES OF PORK LOIN CHOPS

1984 ◽  
Vol 64 (1) ◽  
pp. 39-43 ◽  
Author(s):  
L. E. JEREMIAH ◽  
G. M. WEISS
Keyword(s):  
Key Words ◽  
Slaughter Weight ◽  
Cooking Properties ◽  
Group 4 ◽  
Practical Standpoint ◽  
Group 3 ◽  
Pork Loin ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

A total of 130 barrows and 113 gilts were slaughtered over a range of liveweights from 65.6 to 143.9 kg. These animals were randomly assigned to six different liveweight groups (group 1, less than 79.5 kg; group 2, 79.5 through 93.1 kg; group 3, 93.2 through 106.7 kg; group 4, 106.8 through 120.4 kg; group 5, 120.5 through 134.0 kg; and group 6, 134.1 kg and over) and utilized to evaluate the effects of slaughter weight and sex on palatability and cooking properties. The composite results indicated that the slaughter weight of both barrows and gilts can, from a practical standpoint, be increased to take advantage of potential economic advantages without meaningfully altering cooking losses or palatability attributes. Key words: Pork, slaughter weight, sex, palatability, cooking losses

scholarly journals Fracture resistance of incisal tooth fragment reattached with different adhesive materials and retentive techniques

2018 ◽  
Vol 32 (4) ◽  
pp. 163
Author(s):  
Fábio Herrmann Coelho-de-Souza ◽  
Guilherme Fossá ◽  
Flávia Ávila Pereira ◽  
Celso Afonso Klein-Júnior ◽  
Maria Carolina Guilherme Erhardt ◽  
...  
Keyword(s):  
Bond Strength ◽  
Fracture Resistance ◽  
Shear Bond Strength ◽  
Composite Resin ◽  
Adhesive System ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Adhesive Materials ◽  
Group 1

OBJECTIVE: This study evaluated in vitro the shear bond strength of experimentally fractured human tooth fragments reattached with different adhesive materials and retentive techniques.METHODS: Forty-eight sound mandibular incisors were randomly divided into 6 groups (n=8). Their incisal edges were cut off in 5 groups, representing an enamel-dentin fracture. Intact teeth were used as control (Group 1). The fragment edges were reattached with adhesive system (Scotch Bond Multipurpose – 3M ESPE) (Group 2), adhesive system and composite resin (ICE – SDI) (Group 3), adhesive system and composite resin with circumferential bevel (Group 4), adhesive system and composite resin with internal dentin groove (Group 5), and adhesive system and composite resin with the circumferential bevel and internal dentin groove (Group 6). Shear bond strength was determined in a universal testing machine. Fracture modes were identified by light microscope. Kruskal-Wallis was used to analysis resistance to fracture and fracture patterns.RESULTS: The results showed statistically significant differences (p<0.05) among groups. The intact teeth (Group 1) showed higher fracture resistance than the other groups. Groups 2 and 6 did not differ and were statistically superior to other techniques. Group 4 presented statistically higher than in Group 5, which in turn was more resistant than Group 3.CONCLUSIONS: None of the fragment reattachment techniques was able to achieve the strength of sound teeth. Fragments reattached only with adhesive system or with adhesive system and composite resin with the circumferential bevel and internal dentin groove showed the best performance for resistance to fracture.

scholarly journals Zingerone Ameliorates Hepatotoxicity

2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.
Keyword(s):  
The Body ◽  
Control Group ◽  
Medical Sciences ◽  
Toxic Compounds ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

Sign in / Sign up

Export Citation Format

Share Document