Analysis of Cesarean Section Causes Using Robson’s Ten Group Classification System in Selected Hospitals Affiliated to Shiraz University of Medical Sciences: A Cross-sectional Study

Abstract

Background: Robson’s Ten Group Classification System (RTGCS) is widely used to evaluate, monitor, and compare cesarean delivery (CD) rates within and between delivery service centers. This study aimed to investigate the causes of CD in Shiraz teaching hospitals using RTGCS. Materials and Methods: A cross-sectional study on 1787 pregnant women who underwent CD in selected teaching hospitals in Shiraz, Iran, was selected via convenience sampling within 3 months. The data collection tool was a demographic, midwifery, and fertility information questionnaire completed through interviews and medical records. Subjects’ classification was performed based on midwifery concepts and parameters described in RTGCS. The Robson's 10-group classification is based on simple obstetrical parameters (parity, previous CS, gestational age, onset of labour, fetal presentation, and number of fetuses). Data were analyzed using SPSS software and descriptive tests were used to describe the data. Results: Of the 1787 subjects, 455 (25.5%) had planned CS and 1332 (74.5%) had emergency CS. The most common causes of CD were previous CD (58.6%) and fetal distress (27.6%). Overall, 823 (46.1%) had fetal and placental causes, 1268 (71%) had uterine causes, and 78 (4.4%) had maternal causes. Conclusion: The biggest factors that played a role in the CD rate in the present study were termed multipara women with a history of previous CD. The CD rate and the overall size of this group are still increasing, and as a result, women with a history of a previous CD must be motivated more effectively to have a vaginal birth after cesarean delivery (VBAC).