Identification of obstetric targets for reducing cesarean section rate using the Robson Ten Group Classification in a tertiary level hospital

Triunfo, Stefania; Ferrazzani, Sergio; Lanzone, Antonio; Scambia, Giovanni

doi:10.1016/j.ejogrb.2015.03.030

Cited by 49 publications

(77 citation statements)

References 23 publications

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“…2 The size of group 5 is usually related to the overall cesarean rate, and if this group is large or over 15%, it could mean that the cesarean rate is high in that particular setting. [2][3][4][5][6]13,15,17 The cesarean rate in this group was noticeably lower in our study at 55.5%. 2,4 Our study also indicated that Robson groups 2b and 4b, planned cesarean at term, were relatively small at 0.3% and 0.7%.…”

Section: Discussioncontrasting

confidence: 53%

“…[2][3][4][5][6] However, two studies from developed countries with low rates-The Netherlands 7 and the Nordic countries 8 -indicate that the largest contributing groups to the cesarean rate are nulliparous women followed by women with a previous cesarean. Findings from countries with high rates-Australia, Singapore, Brazil, and Italy-indicate that women with a previous cesarean contributed the most to the cesarean rate followed by women who underwent an induction or an elective cesarean at term.…”

mentioning

confidence: 99%

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The Robson 10‐group classification in Iceland: Obstetric interventions and outcomes

Einarsdóttir

Sigurðardóttir

Bjarnadóttir

et al. 2019

Birth

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Background Rising cesarean rates call for studies on which subgroups of women contribute to the rising rates, both in countries with high and low rates. This study investigated the cesarean rates and contributing groups in Iceland using the Robson 10‐group classification system. Methods This study included all births in Iceland from 1997 to 2015, identified from the Icelandic Medical Birth Registry (81 839). The Robson distribution, cesarean rate, and contribution of each Robson group were analyzed for each year, and the distribution of other outcomes was calculated for each Robson group. Results The overall cesarean rate in the population was 16.4%. Robson groups 1 (28.7%) and 3 (38.0%) (spontaneous term births) were the largest groups, and groups 2b (0.4%) and 4b (0.7%) (prelabor cesareans) were small. The cesarean rate in group 5 (prior cesarean) was 55.5%. Group 5 was the largest contributing group to the overall cesarean rate (31.2%), followed by groups 1 (17.1%) and 2a (11.0%). The size of groups 2a (RR 1.04 [95% CI 1.01‐1.08]) and 4a (RR 1.04 [95% CI 1.01‐1.07]) (induced labors) increased over time, whereas their cesarean rates were stable (group 2a: P = 0.08) or decreased (group 4a: RR 0.95 [95% CI 0.91‐0.98]). Conclusions In comparison with countries with high cesarean rates, the prelabor cesarean groups (singleton term pregnancies) in Iceland were small, and in women with a previous cesarean, the cesarean rate was low. The size of the labor induction group increased, yet the cesarean rate in this group did not increase.

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Section: Discussioncontrasting

confidence: 53%

mentioning

confidence: 99%

The Robson 10‐group classification in Iceland: Obstetric interventions and outcomes

Einarsdóttir

Sigurðardóttir

Bjarnadóttir

et al. 2019

Birth

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show abstract

“…This finding conforms with the literature, as being nulliparous was identified as a contributor to the likelihood of a cesarean section [10,11] . In the present study, we established that women older than 35 years were more likely to have a cesarean section, which corresponds to results from recent research.…”

Section: Parity and Agesupporting

confidence: 81%

Cervical ripening with an osmotic dilator (Dilapan-S) in term pregnancies – An observational study

Maier¹

2015

JGNB

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Objective: The procedure of labor induction becomes increasingly important as the number of pregnancies requiring induction rises in the Western countries due to multiple reasons. In addition, a growing number of patients is aiming to achieve vaginal birth after cesarean section (VBAC). No pharmacological agent is licensed in this group of patients. A newly developed hydrophilic agent (Dilapan-S) is now available for cervical ripening, and is indicated also for patients with a previous cesarean section. Methods: Observational, non-interventional study in a tertiary perinatal center in Berlin, Germany in 2014. Eighty-three women at term with a singleton pregnancy and cephalic presentation were included. Results: In total, 60.2% of patients delivered vaginally, 4.8% by ventouse/forceps and 34.9% by secondary cesarean section. Parous women were found to have a significantly higher chance of vaginal birth (82.6% vs. 60.2% in total, p = 0.019). Patient's ≥ 35 years showed a tendency towards increased rates of ventouse and cesarean section (11.1% vs. 4.8% and 38.9% vs. 34.9% respectively). There was a tendency towards a higher rate of vaginal birth in patients with previous cesarean section (66.7% vs. 59.2%). No adverse fetal or maternal outcomes were noted. Conclusions:The application of Dilapan-S is cost-effective as patients can be seen in outpatient care. The device is efficient and safe. It is an attractive option for physicians and patients to lower the cesarean section rate by facilitating VBAC.

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“…Thus considering only obstetric history, women who have previously had a caesarean section are an increasingly important determinant of overall caesarean section rate as observed in the literature. 10,14 Caesarean indications in these patients in group 1 are usually dominated by the acute fetal distress, fetal-pelvic disproportion and the relevance of such indications is based on a number of means of monitoring and diagnosis that we do not always have in our hospitals. So a caesarean indication in nulliparous must be discussed, discussed again in order to make it relevant and absolute that can help save the maximum number of first Caesarean section.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,6 Our rate is also higher than the average rate in France (15.5-20.8%), in Canadian (26,9%), however, our rate of the second period (41.7%) is comparable to those of public hospitals in Italy (43.7%) and Greek (41.6%). [7][8][9][10][11] But one thing is clear, there is a considerable increase in the CS rate as well in developing countries than in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Analysis of caesarean rate and indications of university hospitals in sub-Saharan African developing countries using Robson classification system: the case of Cocody's hospital center, Abidjan-Cote d'Ivoire

Loue

Gbary

Koffi

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Identification of obstetric targets for reducing cesarean section rate using the Robson Ten Group Classification in a tertiary level hospital

Cited by 49 publications

References 23 publications

The Robson 10‐group classification in Iceland: Obstetric interventions and outcomes

The Robson 10‐group classification in Iceland: Obstetric interventions and outcomes

Cervical ripening with an osmotic dilator (Dilapan-S) in term pregnancies – An observational study

Analysis of caesarean rate and indications of university hospitals in sub-Saharan African developing countries using Robson classification system: the case of Cocody's hospital center, Abidjan-Cote d'Ivoire

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