scholarly journals Results of Using the Robson Classification in Kazakhstan

2021 ◽  
Vol 9 (B) ◽  
pp. 663-669
Author(s):  
Assel Askarovna Altayeva ◽  
Saule Shaykenovna Issenova ◽  
Egle Machtejeviene ◽  
Gani Zhandiyarovich Bodykov ◽  
Balzira Nagashibaevna Bishekova
Keyword(s):  
Cesarean Section ◽  
Computer Application ◽  
World Health ◽  
Operative Delivery ◽  
Robson Classification ◽  
Relative Contribution ◽  
Nulliparous Women ◽  
Level Ii ◽  
The World ◽  
Health Organization

BACKGROUND: Over the past few decades, the cesarean section frequency has increased significantly in many countries around the world, especially in the countries with high and medium income. The World Health Organization recommends 10–15% as the optimum cesarean section frequency. In Kazakhstan, the frequency of operative delivery in 2018 was 23.5%. AIM: The article is aimed at analyzing the caesarean section frequency following the Robson classification in Kazakhstan at Level II and III obstetric institutions, identifying the groups that make the greatest contribution to the overall cesarean section frequency, studying the clinical reasons in these groups, and identifying the ways to reduce unneeded cesarean sections. METHODS: A prospective study was performed at the Level II and III obstetric facilities in Almaty. On admission for delivery, all women were assigned following the Robson classification. The indices of cesarean section in each of 10 groups and the absolute and relative contribution to the overall cesarean section frequency were calculated. The patient data were prospectively entered into a computer application and processed in MS Excel and Statistica version 23. The results were presented using the Robson classification. The odds ratios were calculated with a confidence interval of 95%. RESULTS: For the period from January 1, 2019, to December 31, 2019, 12,395 women parturiated at Level II and III obstetric facilities. The main contributors to the overall cesarean section frequency at Level II and III obstetric facilities were Group 5 (multiparous women with uterine scars) – 46.3% (Level II facility) and 37.5% (Level III facility), Group 2 (12.4%) and (12.4%), Group 1 (12%) and (9.6%), and Group 10 (11.4%) at the Level III facility. CONCLUSION: The Robson classification has been used for the 1st time in Kazakhstan which has made it possible to identify the reasons that make the greatest contribution to the overall cesarean section frequency. The use of monitoring for analyzing the cesarean section frequency will make it possible to compare the Kazakhstan data with the foreign data and determine the organizational measures aimed at reducing the frequency of operative delivery. The strategies to reduce unneeded cesarean section should focus on reducing the cesarean section frequency in nulliparous women. In the absence of contraindications, natural delivery should be advised to the women with uterine scars.

scholarly journals Cesarean sections in Brazil’s teaching hospitals: an analysis using Robson Classification

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Yluska Myrna Meneses Brandão e Mendes ◽  
Daphne Rattner
Keyword(s):  
Information System ◽  
Cesarean Section ◽  
World Health Organization ◽  
World Health ◽  
Teaching Hospitals ◽  
Cesarean Sections ◽  
Cross Sectional ◽  
Robson Classification ◽  
The World ◽  
Health Organization

Objective. To determine the distribution of cesarean sections performed in teaching hospitals participating in the Project for Improvement and Innovation in the Care and Teaching of Obstetrics and Neonatology (Apice ON) using the Robson Classification. Methods. Cross-sectional descriptive study on cesarean sections performed at Apice ON hospitals according to the Robson Classification, using secondary data from the 2017 Live Births Information System on the year prior to project implementation, hence a baseline study. Hospitals are described according to their geographic distribution and cesarean section rates, using absolute and relative frequencies. Results. The proportions of newborns by Robson groups were similar to those proposed by the World Health Organization, except for Group 5 (with previous cesarean section) and Group 10 (preterm), with regional differences. The teaching hospitals’ average cesarean section rates ranged from 24.8% to 75.1%, exceeding by far the recommended values, even in Robson groups considered low risk for cesarean section (Groups 1 to 4). Conclusions. Brazilian teaching hospitals displayed cesarean section rates higher than those recommended by the World Health Organization for all groups; a worrisome fact, as by teaching they induce attitudes in future professional practices. These results highlight the importance of a reliable information system. Monitoring and evaluation of cesarean sections using the Robson Classification can be an important tool to guide management and propose actions to reduce rates. Countries with high cesarean section rates might explore this hypothesis in their teaching hospitals in order to define policies for the reduction of their rates.

scholarly journals Prevalence of Cesarean Section Based on Robson’s Classification in Selected Delivery Centers of Shiraz University of Medical Sciences

2020 ◽  
Vol 21 (7) ◽  
Author(s):  
Zohreh Rookesh ◽  
Mahnaz Zarshenas ◽  
Marzieh Akbarzadeh
Keyword(s):  
Cesarean Section ◽  
Descriptive Statistics ◽  
World Health ◽  
Medical Sciences ◽  
Nulliparous Women ◽  
High Prevalence ◽  
The World ◽  
Group 5 ◽  
Group 2 ◽  
Health Organization

Background: Cesarean section is performed to save the lives of the mother and the fetus. According to the World Health Organization (WHO), the expected cesarean section rate in different countries should be 10% - 15%, which is about 72.1% in Iran. Objectives: Therefore, due to the high prevalence of cesarean section, the present study was conducted to determine the prevalence of cesarean section based on Robson’s classification in selected hospitals of Shiraz University of Medical Sciences. Methods: This descriptive-prospective study was conducted among 1787 women who had undergone a cesarean section in Hazrat Zeinab and Hafez hospitals of Shiraz in 2018. The data were collected by the researcher from the data recorded in the two delivery centers, and all the women were classified into 10 Robson groups. Cesarean section was calculated for each group of Robson’s classification. Data were analyzed using descriptive statistics (frequency and percentage) in SPSS, version 22. Results: Findings showed that 63.4% of the deliveries were performed through cesarean section, and the highest frequency (46.6%) was related to group 5, followed by group 2 (19.5%). Conclusions: Given the high Prevalence of cesarean section observed in this study, it is recommended that the rate of cesarean section should be reduced in nulliparous women (group 2), and vaginal delivery should be increased after cesarean section (group 5).

viewpoint TIME TO RESTART: PROTOCOL OF RESUMPTION OF ACTIVITIES OF A DERMATOLOGICAL CLINIC OF A LEVEL II HOSPITAL IN THE COVID-19 ERA. (Preprint)

2020 ◽  
Author(s):  
Federico Diotallevi ◽  
Anna Campanati ◽  
Giulia Radi ◽  
Oriana Simonetti ◽  
Emanuela Martina ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
World Health ◽  
New Wave ◽  
Staff Members ◽  
Level Ii ◽  
The World ◽  
Health Organization ◽  
Spread Of Infection ◽  
Hospital Wards ◽  
Medical And Healthcare

UNSTRUCTURED Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Since the beginning of the pandemic, a major reorganisation of all hospital wards, including dermatological wards, has been carried out in order to make medical and nursing staff available in COVID wards and to prevent the spread of infection. These strategies, which were also adopted in our clinic, proved to be effective, as no staff members or patients were infected by the virus. Now, thanks to the global decrease in SARS-CovV2 infections, it is necessary to make dermatological wards accessible to patients again, but it is also essential to adopt specific protocols to avoid a new wave of infections.

Robson Classification and quality audit

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gehanath Baral
Keyword(s):  
Cesarean Section ◽  
World Health Organization ◽  
Real Time ◽  
Perinatal Outcome ◽  
World Health ◽  
Related Factors ◽  
Quality Audit ◽  
Robson Classification ◽  
Health Organization

World Health Organization has recommended Robson Classification from baseline obstetric characters to assess, monitor and compare Cesarean Section rates by the quantity analysis. Incorporation of real time labor related factors requires quality audit for both maternal and perinatal outcome.

scholarly journals Optimizing the use of cesarean section in Argentina: design and methodology of a formative research for the development of interventions

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Silvina Ramos ◽  
Mariana Romero ◽  
Carla Perrotta ◽  
Yanina Sguassero ◽  
Cecilia Straw ◽  
...  
Keyword(s):  
Information System ◽  
Cesarean Section ◽  
World Health Organization ◽  
Health Professionals ◽  
Formative Research ◽  
World Health ◽  
Cesarean Section Rate ◽  
The World ◽  
Health Organization ◽  
Type Of Delivery

Abstract Background While cesarean section is an essential life-saving strategy for women and newborns, its current overuse constitutes a global problem. The aim of this formative research is to collect information from hospitals, health professionals and women regarding the use of cesarean section in Argentina. This article describes the methodology of the study, the characteristics of the hospitals and the profile of the participants. Methods This formative research is a mixed-method study that will be conducted in seven provinces of Argentina. The eligibility criteria for the hospitals are (a) use of the Perinatal Information System, (b) cesarean section rate higher than 27% in 2016, (c) ≥ 1000 deliveries per year. Quantitative and qualitative research techniques will be used for data collection and analysis. The main inquiry points are the determining factors for the use of cesarean section, the potential interventions to optimize the use of cesarean section and, in the case of women, their preferred type of delivery. Discussion It is expected that the findings will provide a situation diagnosis to help a context-sensitive implementation of the interventions recommended by the World Health Organization to optimize cesarean section use. Trial registration IS002316 Plain English Summary Cesarean section is an essential medical tool for mothers and their children, but nowadays its overuse is a problem worldwide. Our purpose is to get information from hospitals, health professionals and women about how cesarean section is used in Argentina. In this protocol we describe how we will carry out the study and the characteristics of the hospitals and participants. We will implement this study in seven provinces of Argentina, in hospitals that have more than 1,000 births each year, had a cesarean section rate higher than 27% in 2016 and use the Perinatal Information System. We will gather information using forms, surveys and interviews. We want to identify the factors that decide the use of a cesarean section, the potential interventions that can improve the use of cesarean section and, in the case of women, the type of delivery they prefer. We expect that this study will give us a diagnosis of how cesarean section is used in Argentina, and that this will help to apply the interventions that the World Health Organization recommends to optimize the use of cesarean section in our specific context.

scholarly journals INFLAMMATORY MYOFIBROBLASTIC TUMORS IN THE PECULIAR CONTEXT OF THE POSTPARTUM CASE REPORT

2021 ◽  
Vol 9 (03) ◽  
pp. 607-611
Author(s):  
Khalloufi C. ◽  
◽  
Ibnoulkhatib S. ◽  
El Kebir A. ◽  
Karkouri M. ◽  
...  
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
World Health Organization ◽  
Rare Complication ◽  
Malignant Neoplasm ◽  
World Health ◽  
Pathological Examination ◽  
The World ◽  
Inflammatory Myofibroblastic Tumors ◽  
Health Organization

The debate persists about the inflammatory or tumoral, benign or malignant nature of the Inflammatory myofibroblastic tumors (TMI). Radioclinically, they can mimic a malignant neoplasm, although they are classified as intermediate by the World Health Organization (WHO). The diagnosis is almost always made by pathological examination. The treatment is poorly codified but the management is usually surgical. The removal of these tumors is a challenge when the mass is developed at the expense of or in the vicinity of noble organs. Several therapies have been tested to overcome the limitations of surgery, the results are variable. These tumors rarely affect the digestive tract. We propose the study of a case of myofibroblastic tumor developed at the expense of the omentum, five months after a cesarean section, in order to try to determine if it is a rare complication of the postpartum or a fortuitous combination.

scholarly journals Sugar Restriction for Caries Prevention: Amount and Frequency. Which Is More Important?

2018 ◽  
Vol 53 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Cor van Loveren
Keyword(s):  
Caries Prevention ◽  
World Health ◽  
Sugar Consumption ◽  
The Public ◽  
Sugar Intake ◽  
Relative Contribution ◽  
Dietary Counselling ◽  
The World ◽  
Health Organization ◽  
World Health Organization Guideline

The World Health Organization guideline to use less sugar may be an opportunity and support for dentistry in its goal to get the message of using less sugar across to the public. Two ways (with all the combinations of these) to achieve a reduction of sugar consumption are the reduction of the amount of sugar in products or the reduction of the frequency of consumption of sugar-containing products. Which sugar-reducing strategy is best for caries prevention? To answer this question, this manuscript discusses the shape of the dose-response association between sugar intake and caries, the influence of fluoridated toothpaste on the association of sugar intake and caries and the relative contribution of frequency and amount of sugar intake to caries levels. The results suggest that when fluoride is appropriately used, the relation between sugar consumption and caries is very low or absent. The high correlation between amount and frequency hampers the decision related to which of both is of more importance, but frequency (and stickiness) fits better in our understanding of the caries process. Reducing the amount without reducing the frequency does not seem to be an effective caries preventive approach in contrast to the reciprocity. Goals set in terms of frequency may also be more tangible for patients to follow than goals set in amount. Yet, in sessions of dietary counselling to prevent dental caries, the counsellor should not forget the importance of quality tooth brushing with fluoride toothpaste.

scholarly journals Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System

2020 ◽  
Vol 42 (06) ◽  
pp. 310-315
Author(s):  
Sara Vargas ◽  
Susana Rego ◽  
Nuno Clode
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Tertiary Hospital ◽  
Group Classification ◽  
World Health ◽  
Rate Analysis ◽  
Vaginal Deliveries ◽  
The World ◽  
Obstetric Population ◽  
Health Organization

Abstract Objective The Robson 10 group classification system (RTGCS) is a reproducible, clinically relevant and prospective classification system proposed by the World Health Organization (WHO) as a global standard for assessing, monitoring and comparing cesarean section (CS) rates. The purpose of the present study is to analyze CS rates according to the RTGCS over a 3-year period and to identify the main contributors to this rate. Methods We reviewed data regarding deliveries performed from 2014 up to 2016 in a tertiary hospital in Portugal, and classified all women according to the RTGCS. We analyzed the CS rate in each group. Results We included data from 6,369 deliveries. Groups 1 (n = 1,703), 2 (n = 1,229) and 3 (n = 1,382) represented 67.7% of the obstetric population. The global CS rate was 25% (n = 1,594). Groups 1, 2, 5 and 10 were responsible for 74.2% of global CS deliveries. Conclusion As expected, Groups 1, 2, 5 and 10 were the greatest contributors to the overall CS rate. An attempt to increase the number of vaginal deliveries in these groups, especially in Groups 2 and 5, might contribute to the reduction of the CS rate.

scholarly journals Evidence-based Birth Attendance in Spain: Private versus Public Centers

2019 ◽  
Vol 16 (5) ◽  
pp. 894 ◽  
Author(s):  
Antonio Hernández-Martínez ◽  
Juan Martínez-Galiano ◽  
Julián Rodríguez-Almagro ◽  
Miguel Delgado-Rodríguez ◽  
Juan Gómez-Salgado
Keyword(s):  
Cesarean Section ◽  
World Health Organization ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
World Health ◽  
Cross Sectional ◽  
Birth Attendance ◽  
The World ◽  
Health Organization

The type of hospital (public or private) has been associated with the type of clinical practice carried out. The purpose of this study was to determine the association between the type of hospital (public or private) and delivery attendance with practices based on the recommendations by the World Health Organization (WHO). A cross-sectional study with puerperal women (n = 2906) was conducted in Spain during 2017. The crude Odds Ratios (OR), adjusted (aOR) and their 95% confidence intervals (CI) were calculated through binary logistic regression. For multiparous women in private centers, a higher rate of induced labor was observed (aOR: 1.49; 95% CI: 1.11–2.00), fewer natural methods were used to relieve pain (aOR: 0.51; 95% CI: 0.35–0.73), and increased odds of cesarean section (aOR: 2.50; 95% CI: 1.81–3.46) were found as compared to public hospitals. For primiparous women in private centers, a greater use of the epidural was observed (aOR: 1.57; 95% CI: 1.03–1.40), as well as an increased likelihood of instrumental birth (aOR: 1.53; 95% CI: 1.09–2.15) and of cesarean section (aOR: 1.77; 95% CI: 1.33–2.37) than in public hospitals. No differences were found in hospitalization times among women giving birth in public and private centers (p > 0.05). The World Health Organization birth attendance recommendations are more strictly followed in public hospitals than in private settings.

A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System

2016 ◽  
Vol 8 (3) ◽  
pp. 212-216
Author(s):  
Indra Bhati ◽  
Akriti Jha ◽  
Nishu Agarwal
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Group Classification ◽  
World Health ◽  
Group V ◽  
Global Epidemic ◽  
Nulliparous Women ◽  
Group I ◽  
Group 2 ◽  
Health Organization

ABSTRACT Introduction Cesarean section (CS) is the most common obstetric surgery and one of the most rewarding surgeries performed. The number of CSs has been growing rapidly, and concern has been expressed at the growing rate in some countries, with some referring to it as an emerging “global epidemic.” Aim The purpose of this study was to study the incidence and analyze different indications of CS in our institution and to compare the frequency of CS in Robson's ten group classification system (TGCS). Materials and methods A prospective hospital-based study for a duration of 3 months (January 2012 to March 2012) was conducted in the Department of Obstetrics and Gynecology, Umaid Hospital, Jodhpur. All patients admitted beyond 20 weeks gestation were included in the study, and record of all births during this period was evaluated. Each delivery was then classified into one of ten mutually exclusive categories according to obstetric characteristics. The information was used to identify the group that accounted for largest proportion of women or group that contributed most to CS and identify the areas for potential modification. Results We found cesarean rate of 28.6% during our study period, which is well above the World Health Organization guidelines. Group V (single, term, cephalic, previous CS) was the largest contributor to CS rates (30.4%). Groups I and II were the 2nd and 3rd largest contributors, i.e., 27.5 and 17.5% respectively. Maximum CS rate of 100% was found in group IX (abnormal lie), which was within the expected range. Group 2 had CS rate more than that of group I, and IV had a rate more than that of group I, which indicates that induction and cesarean before labor increases cesarean rate in both multiparous and nulliparous women. In our study, Robson's TGCS demonstrated the need to focus on groups I, II, III, and V because the contribution of these groups to overall cesarean rate was 82%. Clinical significance Ten group classification system was found to be a useful framework for auditing and analyzing different CS rates and their reasons. This will help in not only identifying the priority areas for the changes in clinical practice but also reducing cesarean rate. How to cite this article Bhati I, Jha A, Agarwal N. A New Way of Evaluating Cesarean Section Birth: The Robson's Ten Group Classification System. J South Asian Feder Obst Gynae 2016;8(3):212-216.

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