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

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).

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

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1420 ◽

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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Results of Using the Robson Classification in Kazakhstan

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6398 ◽

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.

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When to resume bariatric surgery after COVID-19 pandemic?: results of patients’ and surgeons’ survey

BMC Surgery ◽

10.1186/s12893-021-01145-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Alicja Dudek ◽

Michał Wysocki ◽

Maciej Walędziak ◽

Jacek Szeliga ◽

Monika Proczko-Stepaniak ◽

...

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

World Health ◽

Online Surveys ◽

The World ◽

Bariatric Patients ◽

Group 2 ◽

Health Organization ◽

Current Body Mass Index ◽

Group 1

Abstract Background Coronavirus Disease 2019 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state. Methods The study was conducted in two groups: Group 1—bariatric patients; Group 2—bariatric surgeons. Two online surveys were distributed. Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p < 0.001) and contact with COVID+/quarantined persons (p < 0.001) had impact on the response to resumption of bariatric procedures. Conclusions Patients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.

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A Case of Polyneuropathy Following a Single Dose of Diethylcarbamazine and Albendazole During Mass Administration of Drug - A Case Report

Nepal Journal of Medical Sciences ◽

10.3126/njms.v1i1.5800 ◽

1970 ◽

Vol 1 (1) ◽

pp. 56-58

Author(s):

SC Kohli ◽

UK Shrestha ◽

VM Alurkar ◽

A Maskey ◽

M Parajuli ◽

...

Keyword(s):

Abdominal Pain ◽

Single Dose ◽

Case Report ◽

Side Effects ◽

World Health Organization ◽

Mass Drug Administration ◽

World Health ◽

Medical Sciences ◽

The World ◽

Health Organization

The global program to eliminate Lymphatic Filariasis created by The World Health organization in 1997 is based on mass administration of single annual doses of diethylcarbamazine ( DEC) plus albendazole in non African regions and of albendazole plus ivermectin in Africa. The usual side effects of DEC treatment include fever, chills, arthralgia, headaches, nausea, and vomiting. Albendazole is associated with relatively few side effects consisting of occasional nausea, vomiting, abdominal pain, headache, reversible alopecia, elevated aminotransferases and rarely leucopenia and rash. We report a case of polyneuropathy in a young individual following DEC and albendazole during mass drug administration. Keywords: Albendazole; DEC; Polyneuropathy. DOI: http://dx.doi.org/10.3126/njms.v1i1.5800 Nepal Journal of Medical Sciences. 2012; 1(1): 56-58

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When to Resume Bariatric Surgery after COVID-19 Pandemic? – Results of Patients’ and Surgeons’ Survey.

10.21203/rs.3.rs-39705/v1 ◽

2020 ◽

Author(s):

Aicja Dudek ◽

Alicja Dudek ◽

Michał Wysocki ◽

Maciej Walędziak ◽

Jacek Szeliga ◽

...

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

World Health ◽

Online Surveys ◽

The World ◽

Bariatric Patients ◽

Group 2 ◽

Health Organization ◽

Current Body Mass Index ◽

Group 1

Abstract BackgroundCOVID-19 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state.MethodsThe study was conducted in two groups: Group 1 – bariatric patients; Group 2 – bariatric surgeons. Two online surveys were distributed.Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p<0.001) and contact with COVID+/quarantined persons (p<0.001) had impact on the response to resumption of bariatric procedures.ConclusionsPatients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.

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A recent update of the diagnostic methods for tuberculosis and their applicability in Indonesia: a narrative review

Medical Journal of Indonesia ◽

10.13181/mji.v28i3.2589 ◽

2019 ◽

Vol 28 (3) ◽

pp. 284-91

Author(s):

Tri Nugraha Susilawati ◽

Riska Larasati

Keyword(s):

Delayed Diagnosis ◽

Diagnostic Methods ◽

World Health ◽

Current State ◽

Interferon Gamma Release Assays ◽

High Prevalence ◽

The World ◽

Golden Standard ◽

Tertiary Hospitals ◽

Health Organization

Tuberculosis (TB) is a major global problem, especially with the high prevalence of HIV-TB co-infection. Delayed diagnosis and continual transmission contribute to high mortality in Indonesia, which has the third highest incidence of TB in the world, after China and India. Therefore, early diagnosis is needed to reduce the number of cases and to administer therapy to prevent the transmission of bacteria. The diagnosis of TB remains a challenge in clinical practice due to poor sensitivity and the requirement of skilled staff in microscopic tests, the slow growth Mycobacterium in culture, and the low number of bacilli present in extrapulmonary TB. Despite being the golden standard for TB diagnosis, cultures require 2–8 weeks to grow. Other methods for diagnosing TB include interferon-gamma release assays and serologic tests such as the tuberculin skin test. Recently, the World Health Organization recommended the GeneXpert MTB/RIF assay for diagnosing TB. This review presents the current state of TB epidemiology and various methods for TB diagnosis. In particular, the paper provides an in-depth discussion about the GeneXpert MTB/RIF assay that has been made available recently in selected tertiary hospitals in Indonesia.

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

Reproductive Health ◽

10.1186/s12978-021-01080-4 ◽

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.

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WORLD HEALTH ORGANIZATION - SCENE OF AMERICAN-CHINESE CONFRONTATIONS

Ante Portas - Studia nad bezpieczeństwem ◽

10.33674/320196 ◽

2020 ◽

pp. 75-83

Author(s):

Svetlana CEBOTARI ◽

Victoria BEVZIUC

Keyword(s):

International Relations ◽

World Health Organization ◽

Research Topic ◽

World Health ◽

Medical Sciences ◽

Global Pandemic ◽

The World ◽

The Usa ◽

Health Organization

The activity of the World Health Organization is now becoming a topic in disputes between the big power centres – the USA and China. The role of the WHO is also becoming a research topic not only for researchers in medical sciences, but also for political specialists in international relations. With the COVID-19 crisis, the WHO is becoming a scene of the major challenges – the USA and China. This Article aims to highlight the USA and China relations with reference to the work of the WHO, including the effectiveness of the organization with a global pandemic such as that of the COVID-19.

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A review of the prevalence and factors responsible for mal-nutrition in Pakistan

Pakistan Journal of Pharmaceutical Research ◽

10.22200/pjpr.2015133-37 ◽

2015 ◽

Vol 1 (1) ◽

pp. 33

Author(s):

Hafsa Hina ◽

Saima Khanum ◽

Muhammad Hanif

Keyword(s):

International Organizations ◽

Preventive Measures ◽

World Health ◽

Childhood Malnutrition ◽

Under Nutrition ◽

High Prevalence ◽

The World ◽

Development Goals ◽

Health Organization ◽

Height For Age

Problems occupying special attention identified by the World Health Organization also include Childhood malnutrition (Beagle hole et al., 1993). Development goals are also program by the United Nations to halve the problem of under nutrition (Alderman et al., 2005). Despite of the involvement of international organizations still under nutrition has a main contribution to the high mortality rate of the children in the most part of the world (Caulfield et al., 2004). Poverty plays a main part in the high prevalence of childhood under nutrition. The child is said to be under-weight when its weight is lower than the weight of the reference rage for that age. The weight for height deficiency is known as wasting, while height for age deficiency as stunting. Wasting may be due to acute food shortage while prolonged food deprivation can cause stunting (Cosminsky et al., 1993; de Onis et al., 2000; Fernandez et al., 2002; and Zere & McIntyre, 2003). The factors responsible for the predisposition of children to mal nutrition vary and ranges from political instability to the economical status of the area (de Onis et al., 2000). Therefore protocols developed for the preventive measures of mal-nutrition should be multifaceted.

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AUDIT OF CESAREAN SECTION IN A RURAL TEACHING HOSPITAL AS PER WHO GUIDELINES (ROBSON’S TEN GROUP CLASSIFICATION SYSTEM)

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i8.2061 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Priyanka Sharma ◽

Apra Attri

Keyword(s):

Cesarean Section ◽

Breech Presentation ◽

Background Rate ◽

Medical College ◽

Nulliparous Women ◽

Group 5 ◽

Group 2 ◽

Rural Teaching ◽

Presentation Group ◽

Group 1

Background: Rate of cesarean section (CS) is one of the most frequently used indicators of healthcare quality at the national and international levels for clinical governance. Audit of indications of CS and to propose measures to reduce the rate of CS in our institution Methods: Prospective observational study was conducted at Department of Obstetrics and Gynaecology at Dr Rajendra Prasad Government Medical College Kangra at Tanda (HP) Results: In our study, previous CS (group 5) contributed the most (30.44%) of overall CS.Second largest contributor was nulliparous women with cephalic presentation at term (group 1 and 2).Induction of labor (group 2) was associated with higher CS (23.66%), as compare spontaneous labor (group1). Women with breech presentation (group 6 and 7) also showed high CS rate. Conclusion: In conclusion, RTGCS permits the easy identification of the leading contributing groups to CS increases. RTGCS is an internationally accepted classification that is much needed to scientifically study the effects of the rising CS rate. It identifies the contributors to differences in the CS rate but does not provide any explanation for these differences across various subgroups. Keywords: RTGCS, CS, NVD, Women.

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