Rates and Indications of Cesarean Section Using the Robson Classification in a University Hospital in Southern Thailand 2014-2016

Abstract

<jats:p>Objective: To identify the rates and indications of cesarean section (CS) using the Robson classification during 2014- 2016 in a university hospital in southern Thailand. Material and Methods: A cross-sectional study of women who delivered between January 1, 2014 and December 31, 2016 was conducted. The data were analyzed using the Robson classification. Results: A total of 10,474 births were included in the analysis. The overall CS rate was 55.5%. The trends of CS rates in most Robson classification groups over the 3-year period were static. The CS rates in nulliparous or multiparous women with induction of labor decreased over the 3-year period, while the rate in multiparous women with fetal breech presentation increased. Women with previous cesarean section (Robson group 5) were the largest contributor to the overall CS rate (32.1%), followed by the nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation in spontaneous labor (Robson group 1) (24.5%). Cephalopelvic disproportion and fetal distress were the most common indications for CS in Robson group 1. Conclusion: The CS rates in our study were high in all groups during the 3-year period, with static trends in most groups. The Robson classification is a feasible tool for monitoring CS rates in our setting. Feedback of these findings to healthcare providers and policy makers is advised.</jats:p>

Incidence of Preeclampsia and Cesarean Section Rate According to the Robson Classification

“…However, all the CS rates exceeded these expectations, which might be due to many factors, including information the women received during antenatal care, cultural beliefs and norms, variations in intrapartum decision-making, and fear of medio-legal claims, which varied in different contexts of care. Group 1 had the highest contribution of 27.2%, which was similar to what was observed from previous studies in Thailand as well [ 11 , 12 ]. The high CS rate in group 1 of 32.5% of the women and as high as 30.8% in those without preeclampsia will need to be explored more in detail, and further specific interventions should be designed to reduce such a high rate.…”

“…The results showed that the overall CS rate was 40.6%. The rate was slightly lower than the previous report from the same institution of 48.9% and 55.5% from the other tertiary care university hospitals [ 11 , 12 ]. This might be from various efforts over the past few years to reduce unnecessary CS.…”

“…In Thailand, recent reports from two university hospitals showed that the overall CS rates were as high as 48.9% and 55.5% [ 11 , 12 ]. Nonetheless, there are only a few previous studies that related the Robson classification to women with some obstetric characteristics or specific conditions [ 4 , 13 , 14 ].…”