Analysis of cesarean section using Robson's ten group classification system in a tertiary care center from Southern India: A cross-sectional study

Abstract

Background: The rising cesarean section (CS) rate is a global concern and World Health Organization in 2015 has proposed the use of Robson-10 group classification system as a standard for assessing and monitoring CS both within and across the healthcare facilities. Objective: The objective is to analyze the CSs performed in a teaching hospital using Robson 10-group classification system. Methodology: The present cross-sectional study was done over a period of 1 year from May 2017 to April 2018. All eligible women delivered in JIPMER, a tertiary care referral center during the study period were classified as per Robson Ten-Group classification system. Caesarean delivery rates were reported. The relative and absolute contribution to CS rates in each groups were calculated. Epi data V.3.1 was used for data analysis. Results: Among 16,863 women delivered during the study, the CS rate was 21.4%. The three common indications for CS overall were fetal distress, nonprogress of labor, and cephalopelvic disproportion. Group 1 (nulliparous, singleton, term cephalic, spontaneous labor) was the largest size followed by group 2 (nulliparous, singleton, term cephalic, induced labor) with 25% and 16.9%, respectively. The maximum contribution of CS was by group 5 (multiparous women, singleton, term cephalic, previous uterine scar) followed by group 2 with 34.9% and 18.9%, respectively. Conclusion: Robson group 5, 2, and 1 were the major contributions to CS in our hospital. Further studies are needed to study the appropriateness of indications for CS especially in groups 2 and 1 as they are the future group 5.