Analysis of Cesarean Section Using Robson’s 10-Group Classification at a Tertiary Level Hospital in Nepal

Abstract

Introduction: Obstetric Services commenced at the teaching institute where this study was conducted from Aug 2012. Hence, a review of the data of C-section in this hospital is needed for standardisation of the obstetric services in terms of the rate of C-section, its various clinical indications and maternal and fetal outcomes.Methods: This is a retrospective study carried out over a period of 5 years from Aug 13, 2012 to Aug 11, 2017. All hospital deliveries conducted during the study period were included in this study and the patients’ details obtained from hospital records. All data obtained was recorded in master charts and analysed using SPSS version 23. The caesarean rate, its indications were calculated and categorised into groups according to Robson’s 10-group classification. Results: A total number of 4892 deliveries were conducted over this 5-year study period. C-section was performed in 1104 patients, giving a C-section rate of 22.57%. The most common indications were previous C-section (25.4%), fetal distress (14.3%) and breech presentation (10.3%). Robson’s Group 1 was the highest contributors to the overall CS rate, contributing 28% of all C-sections, followed by Group 5 (26.8%) and Group 3 (15.5%).Conclusions: Nulliparous and multiparous women in term pregnancy in labor and women with previous C-section contribute to more than 70% of overall C-sections at our centre. Hence, close monitoring of these groups of patients, increasing the use of instrumental delivery and practice of vaginal birth after C-section can significantly reduce the C-section rate in our centre.

Magnitude and associated factors of caesarean section deliveries among women who gave birth in Southwest Ethiopia: institutional-based cross-sectional study

“…The present study revealed that the magnitude of CS was found to be 32.5 % indicated that almost twice more than the WHO recommendation of 10–15 % [ 6 ]. The finding was slightly higher than studies conducted in Felegehiwot referral hospital, Amhara region, Northwest Ethiopia 25.4 % [ 16 ], Nepal 22.6% [ 23 ], Vietnam 26.2 %, [ 26 ], Sri Lanka, India 25 % [ 11 ], Mizan-Aman general hospital, Southwest Ethiopia 21 % [ 25 ] and Shire, Tigray region, Northern Ethiopia 20.2 % [ 15 ]. The result was nearly consistent with studies conducted in North Wollo Zone public hospitals, Amhara region, Northeast Ethiopia 30.9 % [ 17 ], Hawassa university referral hospital, southern Ethiopia 32.8 % [ 18 ], and Jugal hospital, Harari Regional State, eastern Ethiopia 29.7 % [ 28 ].…”

“…The explanatory variables for this study were includes; gravidity, categorized as ‘primigravida’, ‘multigravida’ and ‘grand multigravida’; parity, categorized as ‘nulliparous’ or ‘multipara’, ‘Grand multiparous’; fetal lie/presentation, categorized as ‘breech’ or ‘cephalic’, lie ‘transverse or oblique’; onset of labour, categorized as ‘spontaneous’, ‘induced or CS before labour’; malpresentation, categorized as ‘Yes’ and ‘No’; multiple pregnancies, categorized as ‘singleton’ or ‘multiple’; Gestational age, classified as ‘term > 37weeks’, ‘preterm < 37 weeks’ and ‘post-term > 42 weeks’ new-born birth weight; newborn birth weight, categorized as ‘normal birth weight (2500-4000gm)’, ‘low birth weight (< 2500gm)’, ‘macrosomia (> 4000gm)’; previous history of CS, categorized as ‘Yes’ and ‘No’[ 22 , 23 ].…”

Factors Associated with High Rates of Caesarean Deliveries: A Cross Sectional Study Classifying Deliveries According to Robson in Mengo Hospital Kampala

“…In this sense also studies from elsewhere; the caesarean section rate, its indications were calculated and grouped according to Robson’s 10-group classification; The most common indications were previous caesarean section (25.4%), fetal stress (14.3%), and breech presentation (10.3%). 26 , 27 However, results differ from those obtained by Makhanya et al, 22 where the main indications for CS were fetal distress (36.5%) and cephalo-pelvic disproportion (26.8%).…”