Investigating Caesarean Section Practice among Teenage Romanian Mothers Using Modified Robson Ten Group Classification System

Abstract

The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different (p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.

Frequency of Caesarean Section Classified by Robson’s Ten Group Classification System: A Scoping Review

“…A personal obstetrician and educational level were substantially related to the obstetric recommendation for unnecessary CS, per research by Charoonwatana et al [22]. The main recipients to lower CS rates are adolescents in Robson group 1 [16].…”

“…Active management of spontaneous onset of labour in a primigravida, lowering the primary CS delivery rate, following CS, and cautious case evaluation prior to inducing labour in nulliparous women are maybe a few helpful therapies [26]. Matei et al believe that future attention to obstetrical management in Robson groups 7 and 8 is essential [16]. A personal obstetrician and educational level were substantially related to the obstetric recommendation for unnecessary CS, per research by Charoonwatana et al [22].…”

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021

“…The literature demonstrates controversial results related to the particularities of pregnancy evolution and birth in the adolescent population. Some studies report higher percentages of C-sections [ 41 , 42 , 43 ], some report similar C-section rates compared to adult pregnancies [ 44 , 45 , 46 ], and some studies report lower percentages of adolescent C-section birth [ 47 , 48 ]. As depicted in many previous studies, we observed a statistically significantly lower number of C-sections performed for various indications in the pregnant adolescent group when compared with pregnant women between 20 and 24 years old ( p -value less than 0.01).…”

Teenage pregnancy- An unsolved problem of the 21st century. Populational register-based study in Clinical County Hospital Constanta

“…According to multiple studies, the rate of caesarean section in teenage pregnancies, especially primipara with more than 37 weeks of gestation, is 44.59%, exceeding the expectation of the World Health Organisation by almost 15% [9] [10].…”