A study on analysis of cesarean section rate using Robson ten group criteria in a rural tertiary centre Karnataka

Abstract

Introduction: Cesarean delivery is one of the most widely performed surgical procedures in obstetrics worldwide. There is a progressive increase in cesarean deliveries across the world, both in developed as well as in developing countries1. There was an upward trend in the cesarean delivery rate as there were no reliable and internationally standardized data enabling a global comparison for the indications of cesarean deliveries. Hence, in 2014, the WHO proposes the Robson Ten Group Classification system as a global standard for assessing, monitoring, and comparing cesarean delivery rates within healthcare facilities over time and between facilities.4 Methodology: This was a retrospective study on 196 patients undergoing cesarean delivery over a period of 6 months and were classified according to Robson’s 10 group classification in a rural tertiary care hospital in Dakshina Kannada., to see which clinically relevant groups contributed most to the cesarean deliveries. Results: In the present study, the age distribution was between 19 years and 41 years with a maximum of 120 patients in the age group was 21-30 years accounting for 61.2%. Most of them belonged to the lower class and were unemployed. 85.71 % of the CS was done between 37 and 40 weeks of gestation, many of them were done electively (60.2%). 59.7% of the study population were multiparous women with the most common indication of repeat CS (40.3%).40.3% of the study population were nulliparous with the most common indication for CS among them being fetal distress (17.3%) followed by non-progression of labor (16.3%). The maximum contribution of cesarean was through Robson’s group 5. Conclusion: Caesarean section rate can be reduced by combined efforts at all levels and by encouraging hospital vaginal deliveries of all the primigravida, grand multiparous pregnant women, and those who had previous cesarean section by providing adequate maternal and fetal monitoring during labor and round the clock operative facilities and blood bank facilities in all public and private health institutions.