Caesarean Section Rate and Frequencies of Indications Using Robson–Ten Classifications
DOI:
https://doi.org/10.37762/jgmds.8-4.259Keywords:
Caesarean Section, Robson, , Maternal Morbidity, Obstetrics, GynecologyAbstract
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).
Downloads
Metrics
References
Gonda A, Bukhari S, Karim MT, Karim S. Frequency of caesarean section at a tertiary care hospital. J Sheikh Zayed Med Coll. 2017;8(3):1248-50
Tahir N, Adil M, Fatima S, Khan S. Caesarian sections: frequency and indications at peripheral tertiary care hospital. Pak Armed Forces Med J. 2018;68(2):273-9
Khasawneh W, Obeidat N, Yusef D, Alsulaiman JW. The impact of cesarean section on neonatal outcomes at a university-based tertiary hospital in Jordan. BMC Pregnancy Childbirth. 2020;20:1-9 DOI: https://doi.org/10.1186/s12884-020-03027-2
Mascarello KC, Horta BL, Silveira MF. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Rev Saude Publica. 2017;51:105 DOI: https://doi.org/10.11606/S1518-8787.2017051000389
Chen S, Cheng W, Chen Y, Liu X. The risk of abnormal placentation and hemorrhage in subsequent pregnancy following primary elective cesarean delivery. J Matern Fetal Neonat Med. 2020;33(21):3608-13 DOI: https://doi.org/10.1080/14767058.2019.1581167
Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynaecol. 2018;7(11):4674-7 DOI: https://doi.org/10.18203/2320-1770.ijrcog20184528
Boerma T, Ronsmans C, Melesse DY, Barros AJ, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341-8 DOI: https://doi.org/10.1016/S0140-6736(18)31928-7
Mumtaz S, Bahk J, Khang YH. Rising trends and inequalities in cesarean section rates in Pakistan: evidence from Pakistan demographic and health surveys, 1990-2013. PLoS ONE. 2017;12(10):e0186563 DOI: https://doi.org/10.1371/journal.pone.0186563
World Health Organization. World Health Statistics 2015: WHO statement on caesarean section rates. World Health Organization; 2015. 161 p
Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS ONE. 2016;11(2):e0148343 DOI: https://doi.org/10.1371/journal.pone.0148343
Betran AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it. PLoS ONE. 2014;9(6):e97769 DOI: https://doi.org/10.1371/journal.pone.0097769
Gilani S, Mazhar SB, Zafar M, Mazhar T. The modified Robson criteria for caesarean section audit at mother and child health center Pakistan Institute of Medical Sciences Islamabad. J Pak Med Assoc. 2020;70(2):299-303
Imran F, Alia N, Zaman Z. An audit of cesarean section in Fauji Foundation Hospital Rawalpindi. J Soc Obstet Gynaecol Pak. 2016;6:182-6
Bano R, Mushtaq A, Adhi M, Saleem MD, Saif A, Siddiqui A, et al. Rates of caesarean section and trials and success of vaginal birth after caesarean sections in secondary care hospital. J Pak Med Assoc. 2015;65(1):81-3
Khan MA, Sohail I, Habib M. Auditing the cesarean section rate by Robson’s ten group classification system at tertiary care hospital. Prof Med J. 2020;27(04):700-6 DOI: https://doi.org/10.29309/TPMJ/2020.27.04.3383
Naeem M, Khan MZ, Abbas SH, Khan A, Adil M, Khan MU. Rate and indications of elective and emergency caesarean section; a study in a tertiary care hospital of Peshawar. J Ayub Med Coll Abbottabad. 2015;27(1):151-4
Robson M, Murphy M, Byrne F. Quality assurance: the 10‐Group Classification System (Robson classification), induction of labor, and cesarean delivery. Intel J Gynecol Obstet. 2015;131:S23-7 DOI: https://doi.org/10.1016/j.ijgo.2015.04.026
Schemann K, Patterson JA, Nippita TA, Ford JB, Roberts CL. Variation in hospital caesarean section rates for women with at least one previous caesarean section: a population based cohort study. BMC Pregnancy Childbirth. 2015;15(1):179 DOI: https://doi.org/10.1186/s12884-015-0609-x
Senturk MB, Cakmak Y, Atac H, Budak MS. Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia. Int J Women's Health. 2015;7:693 DOI: https://doi.org/10.2147/IJWH.S83800
Imtiaz R, Husain S, Izhar R. Adoption of Robson's Ten Group Classification System (RTGCS) to analyse caesarean section rates at a tertiary care centre in Pakistan. Ann Abbasi Shaheed Hosp Karachi Med Dent Coll. 2018;23(1):46-52
Yadav RG, Maitra N. Examining cesarean delivery rates using the Robson’s ten-group classification. J Obstet Gynecol India. 2016;66(1):1-6 DOI: https://doi.org/10.1007/s13224-015-0738-1
Samba A, Mumuni K. A review of caesarean sections using the ten-group classification system (Robson classification) in the Korle-Bu Teaching Hospital (KBTH), Accra, Ghana. Gynecol Obstet (Sunnyvale). 2016;6(385):2161-932 DOI: https://doi.org/10.4172/2161-0932.1000385
Bo O, Oh O, Osanyin G, Oe O, Ba O. Effect of training on the knowledge and use of the partograph for low risk pregnancies among health workers in a tertiary hospital in Lagos State, Nigeria. J Community Med Primary Health Care. 2018;30(2):47-54
East CE, Begg L, Colditz PB, Lau R. Fetal pulse oximetry for fetal assessment in labour. Cochrane Database Syst Rev. 2014;(10) DOI: https://doi.org/10.1002/14651858.CD004075.pub4
Rauf B, Ali S. Effectiveness of nifedipine in external cephalic version. J Postgrad Med Inst. 2017;31(4):378-82
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Sadia Ali, Shazia Khattak, Rabeea Sadaf, Shamshad Begum, Nasreen Kishwar
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.