Vol. 3, Issue 11 (2017)
Analysis of caesarean-section rates at an Urban Municipal Maternity Hospital according to Robson's ten group classification system
Author(s): Atul Seth, Rajesh Mishra, Anoushka Sahai, Anuj Kumar
Abstract: Background: Rising caesarean rates have been a matter of concern. The WHO proposes that health care facilities should use the Robson's 10 group classification system to audit their Caesarean sections (CS) rates. This would not only help understand CS rates at individual health facilities but also to identify key population groups, indications in each group and suggest mechanisms to reduce these rates. Methods: This was a cross sectional study for a period of 24 months at a municipal maternity care hospital in an urban setting in Maharashtra, India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group. Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 21.3% of the total Caesareans, followed by Group 1, 8 and 10. All five added contributed to 28.11% of the section rate. The least contribution was by Group 7. Conclusions: The contribution of the various Robson's Group to the total CS rates needs to be analysed. Reducing primary section rates by good clinical interventions like versions, adequate counselling and encouraging for TOLAC, judiciously diagnosing dystocia and non-reassuring fetal status could reduce the contribution of Robson's groups towards the absolute CS rates.