Exploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates

Abstract

Objective The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system. Methods Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE). Results The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson's classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. The results indicate that labor was spontaneous in 2,221 (45%) of the women and was augmented or induced in almost 1,634 cases (33%). The birth indication rate was of 64% for normal vaginal delivery, of 24% for emergency CS, and of 9% for elective CS. The rate of vaginal birth after cesarean was 261 (6%), the rate of external cephalic version was 28 (0.7%), and the rate of induction was 1,168 (21.4%). The prevalence of the overall Cesarean section was 33%; with majority (53.5%) of it being repeated Cesarean section. Conclusion The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.Mahera Abdulrahman's ORCID is https://orcid.org/0000-0001-6271-3776. Ã , distribution; ÃÃ semipartial regression; † eta squared is an effect size measure for one-way or factorial ANOVA; ‡ Omega squared (ω2) is a measure of effect size, or the degree of association for a population.

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson’s Criteria at a tertiary care hospital

“…These figures are similar to a study of Abdul Rahman et al (4.6%). 16 Our findings are lower than the study of Abu Bekar (26.7%). 6 The study at Rawalpindi PEMH 17 shows a lower figure than our study (2.82%).…”

Surgical site infections following caesarean sections at Emirati teaching hospital: Incidence and implicated factors

“…The incidence of the caesarean section was found 17.4% in the present study. The caesarean section rate in the studied hospital is lower than average rate (33.0%) in the United Arab Emirates and lower than the global average rate 3 , 7 , 32 . Many authors believe that caesarean birth rate is affected by multiple contributing factors prevailing at individual, organizational and cultural levels 31 .…”

Brazilian andforeign cesareas in frontier city: robson classification / Cesáreas de brasileiras e estrangeiras em município de fronteira: classificação de robson

“…In numerous situations this procedure has been performed without recommendation, employed for medical convenience or by request of the pregnant woman. [1][2] Cesarean sections can trigger complications that cause harm to the woman and the newborn when performed inopportunely, without real indication. [3][4] For the fetus, the risks include premature birth and increased incidence of admission to the Neonatal Intensive Care Unit (NICU).…”

“…For the woman, harm may occur during the procedure and puerperium. 1 Considering these problems, the World Health Organization (WHO) highlights the need to reduce cesarean rates worldwide. In 1985, rates between 10% and 15% were set as ideal, since rates above this recommendation were not correlated to reduced maternal and infant mortality.…”