scholarly journals Cesarean Section Rate at Lumbini Zonal Hospital, Nepal: An Analysis Using the Robson Ten Group Classification System

2020 ◽  
Vol 7 (1) ◽  
pp. 9-14
Author(s):  
Bishnu Gautam ◽  
◽  
Shree D. Acharya ◽  
Vishnu Prasad Sapkota ◽  
Raut B. Batsal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
World Health ◽  
Cross Sectional ◽  
Study Results ◽  
Group 5 ◽  
Group 1

Background Caesarean section (CS) rates have increased globally. The World Health Organization (WHO) recommends the use of the TenGroup Robson classification as the global standard for assessing appropriateness of CS. Nepal has higher-than-global average rates of CS requiring further investigation into appropriateness. Aim This study aims to investigate the caesarean section rates at tertiary care center in Nepal and make analysis based on the group-10 classification. Methods A retrospective cross-sectional study was carried out from 2016 April -2017 March in Lumbini Zonal Hospital, Butwal, Rupendehi, Nepal. 3,817 women who birth over a 12-month period were analyzed using this classification. The caesarean rate, its indications were calculated and categorized into groups according to Robson’s 10-group classification. Results Women with previous CS (Group 5) comprise the largest proportion (9.4%) of the overall 26.41% CS rate. The second largest contributor was a singleton nulliparous woman with cephalic presentation at term (6.6% of total 26.41%). Caesarean section rates in single breech pregnancies were very high (>65%). Robson’s Group 5 was the highest contributors to overall CS rate contributing 35% of all C-sections, followed by Group 2 (24%), and Group 1 (13%). Conclusion The ten-group classification helped to identify the main groups of the subjects who contribute the most to the overall caesarean section rate. This study results suggest that women with previous CS are at risk for having another CS delivery in subsequent pregnancies and therefore there is an urgent need for a dedicated vaginal birth after caesarean section (VBAC) clinic to support this such women to ensure CS are only done when indicated. Furthermore, reducing the CS rate for nulliparous i.e. Group 1 and 2 would, in the long-term, also reduce the size of Group 5 in the future.

scholarly journals Classification of births according to Robson 10 group classification: an emerging concept to audit the increasing caesarean section rate

2019 ◽  
Vol 8 (10) ◽  
pp. 3915
Author(s):  
Priyanka Kolusu ◽  
Palutla Himabindu
Keyword(s):  
Caesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Care Facilities ◽  
Health Concern ◽  
Cross Sectional ◽  
Group 5

Background: High caesarean birth rates are an issue of international public health concern. Worries over such increases have led the WHO to advice that caesarean section rate should not be more than 15%. WHO proposes that the health care facilities to use the Robson’s 10 group classification system to audit their CS rates. Our aim was to investigate the CS rates in a period of 6 months using Robso’s 10 group classification.Methods: This was a cross sectional study conducted for a period of 6 months from July 2018 to December 2018 in Department of Obstetrics and Gynecology, Siddhartha medical college which is a tertiary care center .All women delivered during this period in labour ward were included. All relevant obstetric information (parity, mode of previous deliveries, previous CS and indications, gestational age, onset of labor) was entered on a questionnaire and classified into Robson’s 10 classes and percentages were calculated.Results: Total number of deliveries in 6 months is 4719 out of which C-sections are 1816 which accounts for 38.48%. Highest contribution was by group 5 and group 2. Together these two groups contribute to 62.4% of the total caesarean sections. Group 6 and group 9 by themselves did not contribute much but within their groups had 100% C-section rates.Conclusions: Robson’s 10 group classification provides easy way in collecting information about caesarean section rate which obtains good insight into certain birth groups. Number of women who attempt VBAC has declined over recent years due to fear of uterine rupture. Reducing primary C-section rates, adequate counseling and changing norms for non-reassuring fetal status could reduce contribution of Robson’s groups towards absolute C-section rates.

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 Increasing rates of cesarean section, an upcoming public health problem: an audit of cesarean section in a tertiary care center of North India based on Robson classification

2017 ◽  
Vol 6 (11) ◽  
pp. 4998
Author(s):  
Vinita Das ◽  
Namrata Kumar ◽  
Varsha Kumari ◽  
Anjoo Agarwal ◽  
Amita Pandey ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Care Center ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
North India ◽  
Cross Sectional ◽  
Group 5 ◽  
One Year

Background: Increasing rates of cesarean section during last three decades has become a cause of alarm since and a need for ongoing studies. Objective of present study was to investigate cesarean section rates as per modified Robsons Criteria and to determine area of concern which requires maximum focus to decrease overall caesarean rateMethods: This cross sectional study was conducted over a period of one year (From January 2016 to December 2016) in the Department of Obstetrics and Gynecology at King George’s Medical University, Lucknow.Results: Total number of deliveries for one year was 8526. Out of them, 4275 (50.1%) were vaginal and 4251 (49.9%) were abdominal. Overall maximum caesarean section rate was contributed by group 5 of modified Robsons criteria i.e. previous section, singleton, cephalic, ≥37 weeks (17.7%).Conclusions: Robson 10 group classification provides easy way in collecting information about Cesarean section rate which obtains good insight into certain birth groups. It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS rate (group 1 and 2) and on increasing vaginal birth after CS (group 5). The caesarean rate is commonest in group 5 that is previous section (17.7%).

scholarly journals Assessment of indications of caesarean section among high risk women by Robson criteria: a prospective study

2018 ◽  
Vol 7 (7) ◽  
pp. 2623
Author(s):  
Kaveri Shaw Patel ◽  
Roma S. Nag
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Care Center ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Group Classification ◽  
Classification Systems ◽  
World Health ◽  
Qualitative Assessment ◽  
Safe Delivery

Background: Caesarean section (CS) is a surgical intervention for safe delivery other than natural vaginal route. World Health Organization (WHO) has recommended ten group classification systems of Robson criteria which we have used to analyse CS at our center. The objective of the study to analyse the lower section caesarian section (LSCS) data under Robson criteria for implementation in regular practice in tertiary care center and to understand the need of it for future practice.Methods: A prospective analysis done for deliveries in Obstetric Department of Shalby Multispecialty Hospital of central India by Robson ten group classification criteria. The study was carried out for the period of two year from April 2016 to April 2018 including antenatal women attending labour room with high risks or referred cases from other centers.Results: The study reflected overall 196 live birth of high risk cases which were having other co morbidities like pre-eclampsia, eclampsia, hypothyroidism, diabetes, acute viral hepatitis. The data compared with Robsons guidelines and reflected that the centre is dealing with high risk primigravida (47.51%, 35-42% Robson criteria) cases with high CS rate (16.8%, group 5). There was multiple pregnancy, group 8, (2.32 %, >1.5-2% Robson Criteria) and preterm births as in group 10, 18.02 % (5% in Robson Criteria), exclusively high.Conclusions: The Robson criteria help to classify the population handled by the canter to develop the strategies for betterment of services. It has limitation in view of qualitative assessment of the data for comorbidities and severity of the disease.

scholarly journals Analysis of caesarean section rate in tertiary care hospital according to Robson`s 10 groups classification

2018 ◽  
Vol 7 (4) ◽  
pp. 1380
Author(s):  
Varija T. ◽  
Veerendra Kumar C. M. ◽  
Chandrasekhar Tarihalli
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Breech Presentation ◽  
Group Classification ◽  
Care Hospital ◽  
Case Series Study ◽  
Group 5

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate.Methods: This case series study was conducted at Vijayanagar Institute of Medical Sciences (VIMS), a tertiary care teaching hospital in Ballari, Karnataka, India. All pregnant women who have been admitted for delivery were enrolled and the data was collected for the women delivered by CS during January 2016 to December 2016 and proportions in various groups as per Robson’s ten-group classification system were calculated.Results: Among a total of 6980 women delivered during study period, 2992 (42.8%) delivered by CS. The CS rates among various groups varied from 100% among women with abnormal lies and group 6-95% (all nulliparous breeches) group 5-94% (Previous CS, single cephalic, >37 weeks) to 10 to 15% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with previous section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.24%) to the total number of CS.Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

scholarly journals The ten group Robson classification: a retrospective study to identify strategies to optimise caesarean section rates

2020 ◽  
Vol 9 (12) ◽  
pp. 5082
Author(s):  
Spandana S. ◽  
Amarpali K. Shivanna
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Care Hospital ◽  
Robson Classification ◽  
Vaginal Deliveries ◽  
Group 5 ◽  
Ongoing Surveillance

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.

scholarly journals Assessment of Caesarean Section Rates at Kathmandu Model Hospital Using the Robson’s Ten Group Classification System

2020 ◽  
Vol 17 (4) ◽  
pp. 491-494 ◽  
Author(s):  
Rekha Poudel ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Group Classification ◽  
Vaginal Birth ◽  
Previous Caesarean Section ◽  
Group 5 ◽  
Group 2 ◽  
Vaginal Birth After Caesarean ◽  
Group 1

Background: Aims of this study was to assess the caesarean section rate and identify the indications contributing to the same using the Robson’s Ten Group Classification System at Kathmandu Model Hospital.Methods: This was a retrospective study conducted at Kathmandu Model Hospital among women who underwent caesarean section from 1 January to 31 December, 2018 and were grouped according to Ten Group Classification System. The overall caesarean section rate and the contribution of each group was calculated.Results: The overall caesarean section rate was 66.1% (494 among 747 total deliveries) in 2018. Nullipara, singleton cephalic, >= 37 weeks, spontaneous labor (Group 1) was the major (24.2%) contributor to the overall caesarean section rate followed by previous caesarean section, singleton cephalic, >=37 weeks (Group 5, 22.6%) and nullipara, singleton cephalic, >=37 weeks, induced or caesarean section before labor (Group 2, 18.8%). Also, the caesarean section rate was 49.5% in nullipara, thus increasing the trend of caesarean section for previous caesarean section in future.Conclusions: Efforts must be focused more on Group 1, 2 and 5 to decrease the increasing trend of caesarean section Promoting vaginal delivery in nullipara and facilitating vaginal birth after caesarean are the most relevant areas of intervention. Keywords: Caesarean section; Robson ten group classification system; vaginal birth after caesarean.

Analysis of caesarean section rates using Robsons ten group classification: the first step

2017 ◽  
Vol 6 (8) ◽  
pp. 3481 ◽  
Author(s):  
Sowmya Koteshwara ◽  
Sujatha M. S.
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Cross Sectional ◽  
Medical College ◽  
Relative Contribution ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: The Caesarean section (CS) rate is steadily increasing worldwide including India. The overall CS rates are reported but rarely the women are classified. According to WHO Robson ten –group classification is useful as a global standard for assessing, monitoring and comparing cesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robsons classification) and analyzing the CS rate in each group.Methods: This was a cross sectional study conducted at JSS Medical College, Mysore. The data was collected for all women delivering in hospital from January 2016-December 2016 and the women were classified according to Robsons 10 group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to CS rate from each group was calculated.Results: Among a total of 5016 women delivering during the study period 37.65% of women were delivered by CS. Maximum no of pregnant women belonged to primigravida group (group 1 and 2). Major contributor to CS rate were primigravida (group 2) at 32.2%. Next contributors were group 5 and group 1 at 28.9 % and 18.6% respectively. Overall the three groups 1, 2 and group 5 contributed to 79.7% of the CS rate while the other group contributed to only 21.3% of CS rate.Conclusions: Applying Robsons criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing primary CS rate and increasing VBAC rates will help to reduce CS rate. 

scholarly journals Analysis of caesarean sections at a tertiary care centre according to Robson’s criteria

2020 ◽  
Vol 9 (8) ◽  
pp. 3445
Author(s):  
Ipsita Mohapatra ◽  
Subha Ranjan Samantaray ◽  
Achanta Vivekanand ◽  
Anandala Manjula ◽  
Buyyani Priyanka
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Group Classification ◽  
Tertiary Care Centre ◽  
Civil Hospital ◽  
Relative Contribution ◽  
Still Births ◽  
Group 5 ◽  
Uterine Scar

Background: There has been a considerable increase in the rate of caesarean sections in the past few decades. Some demographers have argued that this increase is largely affected by the uprising trend of new medically indicated caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. This classification is known as Robson’s classification which has ten groups.Methods: This is a retrospective study which was carried out at Civil Hospital, Karimnagar. The study group included all live births and still births of at least 500 gm birth weight or at least 28 weeks of gestation at Civil Hospital, Karimnagar during the period from October 2019 to December 2019. The data collected was analysed using simple statistical methods like percentage and proportion. The data was grouped according to the Robson’s 10 group classification system. The overall caesarean section rate, size of each group and the relative contribution of each group to the overall CS rate were calculated.Results: The total number of deliveries during the study period was 2493. Out of these, the number of caesarean deliveries was 1345. The caesarean section rate was calculated to be 53.95%. The group 5 (multiparous with at least one previous uterine scar with single cephalic pregnancy ≥37 weeks of gestation) contributed to 38.07% of the total caesarean section rate which is the highest.Conclusions: A regular audit into the number and indications of caesarean sections will definitely help in decreasing the primary and repeat caesarean sections.

scholarly journals An audit of caesarean section rate based on Robson’s ten group classification system

2020 ◽  
Vol 9 (7) ◽  
pp. 2803
Author(s):  
Jishma Jose ◽  
Sendhil Coumary Arumugam ◽  
Syed Habeebullah
Keyword(s):  
Caesarean Section ◽  
Classification System ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Health Concern ◽  
Initial Structure ◽  
Cross Sectional ◽  
Group 5

Background: Caesarean section (CS) rates are rising worldwide and is a major public health concern. There is lack of evidence supporting the maternal and neonatal benefits with the increasing CS rates. Robson’s ten group classification system serves as an initial structure with which caesarean section rates can be analysed. RTGCS helps us to analyse and allow us to bring changes in our practice.Methods: This was a hospital based cross sectional study conducted over a period of 10 months during the year 2018, which involved 1478 pregnant women, out of which 693 underwent CS, those who underwent CS were grouped according to Robson’s Ten group classification system and the data was collected and analyzed.Results: 693 women underwent CS and the overall section rate was 46.88%. Group 5 (previous LSCS) and Group 2 (nulliparous, >37 weeks, induced) contributed the maximum to the overall CS rates (33.9% and 26.3% respectively). The most common indication for caesarean section was previous LSCS (38%), fetal distress (19.2%) and meconium stained liquor (13.7%).Conclusions: Robson’s ten group classification system helps us in auditing the caesarean section rates. Group 5 and 2 contributes the maximum for caesarean section rates. Encouraging and adequate counselling for VBAC, proper training of obstetricians in CTG interpretation would reduce the caesarean section rates.

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