Analysis of Cesarean Sections using Robson’s Ten Group Classification System

Parveen, Rashida; Khakwani, Mehnaz; Naz, Anum; Bhatti, Rabia

doi:10.12669/pjms.37.2.3823

Cited by 19 publications

(32 citation statements)

References 17 publications

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“…According to the World Health Report 2010, 6 million non-medically indicated CS procedures were carried out in 2008, costing approximately $2.32 billion in the United States [18]. The increment in salary of healthcare providers might be one of the leading contributors to unnecessary CS births [19]. Non-medically indicated C-sections place a disproportionately higher financial burden on women and lead to adverse health implications.…”

Section: Economic Burdenmentioning

confidence: 99%

“…Medical costs are typically higher if CS procedures are performed at private healthcare facilities. In addition, CS necessitates a lengthier hospital stay, which increases healthcare expenditure and results in financial deprivation [17,19].…”

Section: Economic Burdenmentioning

confidence: 99%

“…CS can be a significantly life-saving intervention for medically indicated cases [19]. In ideal circumstances, C-sections are performed when vaginal delivery (VD) is contradicted to protect the newborn and the mother from a potentially adverse event [11].…”

Section: Indications and Recommendationsmentioning

confidence: 99%

“…Data suggest that CS increases the baby's risk of developing asphyxia, respiratory distress and other pulmonary infections. Maternal mortality is higher with CS than VD in some settings, most likely due to the adoption of non-medically elective CS [5,19]. Increased illness, injury, and short-and long-term disability have been often linked to CS.…”

Section: Potential Risks and Benefits Of Elective Csmentioning

confidence: 99%

“…Non-medically indicated and/or CS on maternal request should not be promoted since it is a major surgery and involves significant risk compared with the conventional VD [19]. Multiple risk factors should be assessed before adopting the CS procedure to ensure better health of the mother and the baby.…”

Section: Potential Risks and Benefits Of Elective Csmentioning

confidence: 99%

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Caesarean Section on Maternal Request

Sethi¹,

Rajaratnam²,

Abdullah³

2023

New Aspects in Cesarean Sections

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Caesarean section on maternal request (CSMR) is performed in the absence of a standard medical/obstetrical indication in order to avoid vaginal delivery. Globally, there has been an upsurge in CS delivery, which necessitates the urgency to address maternal and foetal health implications, and long-term repercussions. Conceptually, the chapter aims to explore the determinants of increased CSMR, highlight its potential risks and benefits, and discuss the ethical, medico-legal concerns. Findings indicate that medical, psychological, psychosocial, economical, social and cultural determinants might serve as some of the potential influencing factors owing to this serious healthcare concern. Although CSMR has been linked to certain beneficial outcomes (e.g. reduced urinary incontinence and pelvic organ prolapse, reduced rate of PTSD and depression, and lesser intrapartum complications), it still imposes serious maternal (e.g. post-partum haemorrhage and infection, visceral damage, placenta accrete, placental abruption and complications in future pregnancy) and foetal adverse outcomes (stillbirth, asphyxia, respiratory distress and other pulmonary infections). Hence, future approaches and interventions should be directed towards mitigating clinically unrequired CS procedures due to medical malpractices, lack of awareness in women and the underlying determinants of elective CS.

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Section: Economic Burdenmentioning

confidence: 99%

Section: Economic Burdenmentioning

confidence: 99%

Section: Indications and Recommendationsmentioning

confidence: 99%

Section: Potential Risks and Benefits Of Elective Csmentioning

confidence: 99%

Section: Potential Risks and Benefits Of Elective Csmentioning

confidence: 99%

See 3 more Smart Citations

Caesarean Section on Maternal Request

Sethi¹,

Rajaratnam²,

Abdullah³

2023

New Aspects in Cesarean Sections

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Study of Caesarean Section Births in a Tertiary Care Hospital in Mumbai Using Robson Classification System

Rajput,

Changede,

Chavan

et al. 2023

J Obstet Gynecol India

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Application of the Robson Classification in Assessing Cesarean Section Rates: An Audit of a Tertiary Care Hospital’s Gynecology Department in Karachi, Pakistan

Abidi¹,

Abbas²,

Abidi

et al. 2023

Preprint

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Objective: The increasing rate of cesarean sections (CS) is a significant concern for healthcare providers worldwide. The World Health Organization (WHO) recommends that CS rates should not exceed 10-15% at the population level. The Robson classification system is a widely used tool for assessing and comparing CS rates based on the indications and patient population across different hospitals and obstetric populations. This audit report will help identify areas for improvement in obstetric care practices and facilitate the development of strategies to optimize obstetric care and reduce CS rates, thereby improving maternal and neonatal outcomes. Methods: This retrospective study utilizing hospital records was conducted from January 1st, 2022, to December 31st, 2022, at the Department of Obstetrics and Gynecology in Holy Family Hospital, Karachi, Pakistan. During the study period of one year, a total of 449 cesarean sections were conducted, which were classified into the ten groups of The Robson Classification. Group CS rate, Group size, Relative contribution of group to overall CS rate, and Absolute group contribution to overall CS rate was calculated for each group. Overall indications of CS in all groups was analyzed and based on the results interventions were suggested to be implemented to optimize CS. Results: 1464 women were delivered during this one year period. A total of 507 CS were our population of interest. Of the cesarean sections performed, 48.8% (247) were elective and 51.2% (260) were emergency. The Robson classification group 5 (51.9%), group 2 (18.5%), and group 10 (14.4%) respectively were the major contributor to the overall CS rate. The main indications for CS were previous history of caesarean section (32.3%), non-progress of labor (21.15%), and cephalopelvic disproportion (16.92%). Conclusion: It is crucial to develop strategies to decrease the unnecessary CS rate while ensuring safe and appropriate obstetric care. Furthermore, there is a need for further research to identify the underlying factors contributing to the high CS rates and to develop effective interventions to address this issue. Implementation of these strategies may lead to improved maternal and fetal outcomes, reduced healthcare costs, and increased patient satisfaction.

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Analysis of Cesarean Sections using Robson’s Ten Group Classification System

Cited by 19 publications

References 17 publications

Caesarean Section on Maternal Request

Caesarean Section on Maternal Request

Study of Caesarean Section Births in a Tertiary Care Hospital in Mumbai Using Robson Classification System

Application of the Robson Classification in Assessing Cesarean Section Rates: An Audit of a Tertiary Care Hospital’s Gynecology Department in Karachi, Pakistan

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