Improving the Management of High-Risk Pregnancies with the Use of the Robson Classification

Abstract

Objective To analyze the rates of cesarean delivery longitudinally in a university hospital using the Robson classification. Methods Data related to births performed between 2014 and 2018 and recorded in the Maternal and Neonatal Health Information System (Sistema de Informações em Saúde Materna e Neonatal, SISMATER, in Portuguese) were analyzed using the Robson classification. As an aid, we used articles published in the last five years that approach the same topic in other Brazilian maternity hospitals; they were retrieved from the LILACS, MEDLINE, CINAHL, Scopus, Web of Science and Cochrane Library databases. Results There was little variation in the total rate of cesarean sections in the period; however, the profile of each group changed over the years. It was possible to verify a significant reduction in the participation of groups of pregnant women with lower risk and an increase in high-risk pregnancies, attributable to the decrease in beds in the institution, with a greater transfer of patients. In addition, there was a reduction in cesarean sections among the lower-risk groups, while the rate among the higher-risk groups remained stable. Conclusion The use of the Robson classification to stratify cesarean deliveries contributes to a better analysis of the indications for cesarean delivery, enabling the establishment of strategies to reduce the rates, generating a positive impact on hospital management and quality of care.

Trend of incompleteness of the Robson Classification variables in the Live Birth Information (SINASC) in the state of Paraná, Brazil, 2014-2020

“…Despite this, the study of the variables that generate the Robson Classification in the SINASC system and its analysis is fundamental, as it enables the identification of the groups of pregnant women most likely to undergo cesarean section, contributing to the implementation of strategies aimed at reducing cesarean section rates. 2 ),( 26 …”

“…Despite this, the study of the variables that generate the Robson Classification in the SINASC system and its analysis is fundamental, as it enables the identif ication of the groups of pregnant women most likely to undergo cesarean section, contributing to the implementation of strategies aimed at reducing cesarean section rates. 2,26 Thus, the evaluation of the incompleteness of the Robson Classification variables in the SINASC system in the state of Paraná and its trend stands out as a strong point, as it showed that the majority of variables presented low percentages of incompleteness and a decreasing trend, although, improvement in the completion of the "parity", "gestational age" and "number of fetuses" variables, is still necessary. These variables showed an increasing trend especially in the Northwest macro-region.…”

Tendência de incompletude das variáveis da Classificação de Robson no Sistema de Informação sobre Nascidos Vivos (Sinasc) no estado do Paraná, 2014-2020

“…Apesar disso, o estudo das variáveis que geram a Classif icação de Robson no Sinasc e sua análise é fundamental, pois permite identificar os grupos de gestantes mais submetidos à cesárea, contribuindo para a implementação de estratégias, com vistas à redução das taxas de cesárea. 2,26 Assim, a avaliação da incompletude das variáveis da Classificação de Robson no Sinasc do Paraná e sua tendência sobressai como ponto forte, pois mostrou que a maioria das variáveis apresentaram baixos percentuais de incompletude e tendência decrescente, embora ainda seja preciso melhorar o preenchimento das variáveis "paridade", "idade gestacional" e "número de fetos", que apresentaram tendência crescente principalmente na macrorregional Noroeste. Esse diagnóstico pode subsidiar a implementação de políticas públicas direcionando estratégias para o contínuo aperfeiçoamento do Sinasc, com realização de análises periódicas e treinamento dos envolvidos.…”

Gambaran Kriteria Robson pada Ibu Bersalin dengan Preeklampsia

“…8,11 Penelitian yang dilakukan oleh Correa Junior et al, mengatakan bahwasanya penggunan kriteria Robson ini dapat meningkatkan pengelolaan prosedur yang dilakukan di bangsal bersalin. 12 Sanchez et al, mengemukakan bahwa preeklampsia dapat dikaitkan dengan kejadian seksio sesarea yang lebih tinggi pada beberapa kelompok Robson. 13 Preeklampsia itu sendiri menurut American College of Obstetrics and Gynecology (ACOG) adalah suatu keadaan yang menandakan adanya hipertensi dan proteinuria yang terjadi setelah usia kehamilan 20 minggu pada pasien yang sebelumnya normotensif.…”