scholarly journals Caesarean Section Rate and Frequencies of Indications Using Robson–Ten Classifications

2021 ◽  
Vol 8 (4) ◽  
pp. 43-47
Author(s):  
Sadia Ali ◽  
Shazia Khattak ◽  
Rabeea Sadaf ◽  
Shamshad Begum ◽  
Nasreen Kishwar

OBJECTIVES: To determine the caesarean section rate (CSR) and frequency of different indications of caesarean section (CS) in a tertiary care hospital. METHODOLOGY: A retrospective study done in the Department of Obstetrics and Gynecology Hayatabad Medical Complex Hospital Peshawar, a tertiary care hospital, from a period of 1st January 2019 till 31st December 2019. The required data was collected from the patient’s hospital records (clinical charts) with the consent of the hospital ethical committee. RESULTS: The total number of deliveries over the study period was 5611. Out of these 1258 patients were delivered through caesarean section (CS), giving a CSR of 22%. The main contributing groups in our study were Robson Groups R5 (multiparous with prior CS, singleton, cephalic and >37 weeks), R1 (nulliparous, cephalic, singleton >37 weeks in spontaneous labor or CS) and R6 (all nulliparous breeches) with percentages of 21.1%, 17.5% and 12.9% respectively. CONCLUSION: Our study showed Robson Groups 5, 2 and 6 as the major contributors, focusing on these groups could have an impact on decreasing the cesarean section rate in future. Limiting the primary cesarean section rate can affect the overall cesarean section rate (CSR).

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):  
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.


2021 ◽  
Vol 59 (243) ◽  
pp. 1098-1101
Author(s):  
Pratigyan Gautam ◽  
Chanda Karki ◽  
Asmita Adhikari

Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.


Author(s):  
Reena Sharma ◽  
Poojan Dogra

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. Objective of the study was to assess the prevalence and different indications of caesarean section in this institute.Methods: The aim of the study is to analyse the rates and indications of lower segment caesarean section (LSCS) in our institution. We conducted a retrospective study over a period of six months; 1st September 2016 to 1st March 2017 at SLBSGMC Mandi at Nerchowk. Total number of patients who delivered in our hospital during the defined study period was recorded and a statistical analysis of various parameters was done.Results: The total number of women delivered over the study period was 2075, out of which caesarean sections (CS) were 473. The overall CS rate calculated was 22.8%. Previous LSCS was the leading indication to the CS rate.Conclusions: Routine obstetric audits should be done to analyse the various indications of emergency and elective caesarean sections so that protocols and guidelines can be implemented to curtail the increasing trend of caesarean delivery.


Author(s):  
Kamna Datta ◽  
P. Singh ◽  
Namita Chopra

Background: Caesarean section rates have globally risen above the levels that can be considered medically necessary. The aim of the study is to analyze the rate and indications of caesarean sections for primigravidae in the period 2016 to 2018 at a tertiary care hospital in Delhi.Methods: It is a retrospective observational study conducted in the Department of Obstetrics and Gynaecology at PGIMER and Dr RML Hospital, New Delhi. A total of 552 caesarean deliveries in primigravidae were studied.Results: The total deliveries during the study period were 3346 and the total caesarean section rate observed was 30.66%. The caesarean section rate among primigravidae was 29.1%. The rate of caesarean section in primigravidae rose from 22.7% in 2016 to 39.3% in 2018 with 17% increase. Majority of them belonged to the age group 20-30 years (79.34%) and 2.53% were elderly primigravidae. Out of the total number of primigravidae caesarean deliveries, 67.2% were performed in emergency and 32.7% were performed electively. Among the emergency caesarean sections performed, 64% of patients had induced labor and 22% had spontaneous labor. The most common indication of caesarean section was fetal distress (19.77%) followed by arrest of labor (17.87%) and malpresentations (8.9%). The short-term caesarean morbidity rate was 25.4% including one mortality. Wound infection was the most common complication.Conclusions: Various reasons like changing maternal risk profile increased IVF pregnancies, scientific advances, personal choice and medico legal considerations have been cited for increased caesarean rate. Following evidence-based labor protocols, judicious use of cardiotocography, proper patient selection for labor induction and patient education will contribute in reduction of caesarean sections and related complications.


2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Nazia Liaqat ◽  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Nazish Hayat

Background: Caesarean section is a time honoured approach that evolved to save maternal lives in the times of difficult deliveries. The rise in the rates of caesarean section is a matter of concern as being a major surgery, it is associated with risks that can extend for years and affect the health and future pregnancies of women.Objective: This study is carried out to analyses changing trends in the rates and indications of caesarean sections in the last six years in a Tertiary Care Hospital of Peshawar.Materials and Methods: This retrospective study is carried out by collecting record of all deliveries including indications of caesarean sections of the years 2014,2016 and 2018 of the unit. Results: The caesarean rate was 174/1000 total births for year 2014.It was 143 and 176 per 1000 total births for the year 2016 and 2018. The commonest indication for primary caesarean section was fetal malpresentations with rates as 31.5,30.2 and 29.9 per 1000 total births for 2014,2016 and 2018 respectively. Fetal distress was observed as the second commonest indication. Previous 2 or more caesareans was the commonest indication for repeat caesarean sections in all three years , with rise in rates from 21.4 to 28.70 per 1000 total births from 2014 to 2018.Conclusion: The rates of caesarean sections of the last five years on average are close to the WHO rates. Fetal Malpresentations, Distress and Previous two or more caesarean section are the leading indications of caesarean sections.


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