Abstract
The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different (p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.
Highlights
The year before, Cyprus and Romania were the two countries reporting the highest rates of CS *54.8% and 44.1%, respectively), whereas in Finland only 16.5% of all live births came through CS [2]
The primary outcome of our analysis is to describe the obstetric framework using the ten-group classification system (TGCS) implemented in this distinctive group of patients
As regards nulliparous women, 44.59% of them delivered through CS
Summary
Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).In 2018, the caesarean section (CS) was the second most common surgical procedure conducted in the European Union hospitals after cataract surgery, being performed at least 1.4 million times [1,2]. The year before, Cyprus and Romania were the two countries reporting the highest rates of CS *54.8% and 44.1%, respectively), whereas in Finland only 16.5% of all live births came through CS [2]. These prominent differences have been suggested to be related to a variety of factors, ranging from extreme maternal age and their associated obstetrical comorbidities, to the clinician’s experience, fear of litigation or theInt. J. Environ. Res. Public Health 2021, 18, 10727. https://doi.org/10.3390/ijerph182010727 https://www.mdpi.com/journal/ijerph
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