Analyzing trends in Cesarean Section by Action Oriented Classification (Robson Criteria) at Creek General Hospital, Karachi
DOI:
https://doi.org/10.51985/JBUMDC2024420Keywords:
Cesarean Section, Delivery, Pregnancy, Robson.Abstract
Objectives: The objective of this study is to analyze Cesarean section trends using the Robson classification system and identify the cause of cesarean section in each group, in a tertiary care hospital Karachi.
Study Design and Settings: This cross-sectional study was conducted in the obstetric department of Creek General Hospital Karachi, from 1 Jan 2021 to 31 Dec 2022.
Methodology: Data collection utilized a non-probability consecutive sampling method. This study examined the sociodemographic characteristics, indications for cesarean section, and the Robson classification system in the women who underwent cesarean section in the hospital during specified duration.
Inclusion criteria of study were all women who underwent for C-section procedure during the study timeline. Data was analyzed using IBM SPSS Statistics version 26. The study adhered to the Helsinki Declaration and ethical approval. Results: The Robson classification system was analyzed in this study, and group 5 was shown to be the primary contributor followed by group 2 and then group 1. Most frequently noted indication was previous CS (43.2%), followed by non-progress of labor (15.1%), and fetal distress (11.6%).
Conclusion: Cesarean section rate can be reduced by encouraging vaginal birth after cesarean section in multiparous women who had one cesarean section, under supervision of senior obstetrician. Meanwhile, the Non-progress of labor can be targeted by improving antenatal and intrapartum care, birth preparation classes and presence of companion during labor. Through CTG interpretation and their standardized management protocols will be effective in preventing and curbing the rising cesarean rate due to fetal distress
References
1. Keag OE, Norman JE, Stock SJ. Long-term risks and
benefitsassociated with cesarean delivery for mother, baby,
and subsequentpregnancies: systematic review and metaanalysis. PLoS Med.2018;15(1):e1002494. DOI: 10.1371/
journal.pmed.1002494
2. Blustein J, Liu J. Time to consider the risks of caesarean
delivery for long term child health. Bmj. 2015;350. doi:
https://doi.org/10.1136/bmj.h2410
3. Verma V, Vishwakarma RK, Nath DC, et al. Prevalence and
determinants of caesarean section in South and South-East
Asian women. PLoS One. 2020;15(3):e0229906. DOI:https:
//doi.org/10.1371/journal.pone.0229906
4. Amjad A, Imran A, Shahram N, et al. Trends of caesarean
section deliveries in Pakistan: secondary data analysis from
Demographic and Health Surveys, 1990-2018. BMC
Pregnancy Childbirth. 2020;20(1):753. DOI: https://doi.org/10.
1186/s12884-020-03457-y
5. Akadri AA, Odelola OI. A Six Year Review of Caesarean
Sections at Olabisi Onabanjo University Teaching Hospital
Sagamu, South West Nigeria. Nigerian Medical Practitioner.
2017 Jun 5;71(3-4):53-7.
6. Betrán AP, Ye J, Moller A-B, Zhang J, Gülmezoglu AM,
Torloni MR. The increasing Trend in caesarean section rates:
Global, Regional and National estimates: 1990–2014. PLoS
ONE. 2016;11(2):e0148343. https://doi.org/10.1371/journal.
pone.0148343.
7. Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR,
Zhang J, et al. Use of the Robson classification to assess
caesarean section trends in 21 countries: a secondary analysis
of two WHO multi-country surveys. Lancet Glob Health.
2015;3:e260–70. https://doi.org/10.1016/S2214-109X(15)
70094-X.
8. Villar J, Carroli G, Zavaleta N, et al. Maternal and neonatal
individual risks and benefits associated with caesarean delivery:
multicentre prospective study. BMJ. 2007 Nov 17;335(7628)
:1025DOI: 10.1136/bmj.39363.706956.55
9. Souza JP, Gülmezoglu A, Lumbiganon P, et al. Caesarean
section without medical indications is associated with an
increased risk of adverse short-term maternal outcomes: the
2004-2008 WHO Global Survey on Maternal and Perinatal
Health. BMC Med. 2010;8:71 DOI: https://doi.org/
10.1186/1741-7015-8-71
10. World Health Organization. WHO statement on caesarean
section rates. 2015. Accessed 20 September 2023.
DOI:http://apps.who.int/iris/bitstream/10665/161442/1/WH
O_RHR_15.02_eng.pdf?ua=1
11. Robson MS. Classification of caesarean sections. Fetal Matern
Med Rev. 2001; 12: 23–39. DOI: https://doi.org/10.1017/
S0965539501000122
12. Shinwari L, Bukhari B, Irfan S, Faisal R. Comparison of the
rate and indications of caesarean section in primigravida and
multigravida in a maternity hospital of Pakistan. q. The
Professional Medical Journal. 2024; 31(07): 1100-5. doi:
10.29309/TPMJ/2024.3 1.07.7653.
13. Roberge S, Dubé E, Blouin S, Chaillet N. Reporting Caesarean
Delivery in Quebec Using the Robson Classification System.
J Obstet Gynaecol Can. 2017;39(3):152-156. DOI:
https://doi.org/10.1016/j.jogc.2016.10.010
14. Robson M, Murphy M, Byrne F. Quality assurance: The 10-
Group Classification System (Robson classification), induction
of labor, and cesarean delivery. Int J Gynaecol Obstet. 2015
Oct;131 Suppl 1:S23-7. DOI:https://doi.org/10.1016/ j.ijgo.
2015.04.026 2
15. Tahir N, Adil, M, Fatima S, Khan S. Caesarian sections:
frequency and indications at peripheral tertiary care hospital:
Caesarian Sections: Frequency And Indications. Pak Armed
Forces Med J [Internet]. 2018 Apr. 30 [cited 2024 Aug.
21];68(2):273-79. Available from: https://pafmj.org/PAFMJ/
article/view/493
16. Ansari A, Baqai S, Imran R. An Audit of Caesarean Section
Rate Using Modified Robson Criteria at a Tertiary Care
Hospital. J Coll Physicians Surg Pak. 2019;29(8):768-770.DOI:
https://doi.org/10.29271/jcpsp.2019.08.768
17. Fatima SS, Zeb L, Shafqat T, Qazi Q. Analysis of caesarean
section rate according to robson classification criteria: a cross
sectional study in a tertiary care hospital. American Journal of
Health, Medicine and Nursing Practice. 2022;7(5):18-27.
DOI: https://doi.org/10.47672/ajhmn.1009
18. Tontus HO, Nebioglu S. Improving the Caesarean Decision
by Robson Classification: A Population-Based Study by
5,323,500 Livebirth Data. Ann Glob Health. 2020;86(1):10.
DOI: https://doi.org/10.5334/aogh.2615
19. Gilani S, Mazhar SB, Zafar M, Mazhar T. The modified
Robson criteria for Caesarean Section audit at Mother and
Child Health Center Pakistan Institute of Medical Sciences
Islamabad. J Pak Med Assoc. 2020;70(2):299-303. DOI:
10.5455/JPMA.293708
20. Abdo AA, Hinderaker SG, Tekle AG, et alCaesarean section
rates analysed using Robson’s 10-Group Classification
System: a cross-sectional study at a tertiary hospital in
EthiopiaBMJ Open 2020;10:e039098. doi:10.1136/bmjopen-
2020-039098
21. Khan A, Hanif K, Uzma Q, Thome E, Ezra Reza T, et al.
(2023) Analysis of C-section Rates Using Robson’s Ten Group
Classification System (RTGCS) in Pakistan: A Review. ARCH
Women Health Care Volume 6(3): 1–7. DOI: 10.31038/AWHC
.2023634
22. Robson M, Hartigan L, Murphy M. Methods of achieving
and maintaining an appropriate caesarean section rate. Best
Pract Res Clin Obstet Gynaecol. 2013;27(2):297-308. DOI:
https://doi.org/10.1016/j.bpobgyn.2012.09.004
23. O'Riordan N, Robson M, McAuliffe FM. Management of
poor progress in labour. Obstetrics, Gynaecology &
Reproductive Medicine. 2021;31(12):342-50. https://doi.org/
10.1016/j.ogrm.2021.10.003
24. Chinnock M, Robson S. Obstetric trainees' experience in
vaginal breech delivery: implications for future practice.
Obstet Gynecol. 2007 Oct;110(4):900-3 DOI: 10.1097/01.
AOG.0000267199.32847.c4
25. Melo P, Georgiou EX, Hedditch A, Ellaway P, Impey L.
External cephalic version at term: a cohort study of 18 years’
experience. BJOG: An International Journal of Obstetrics &
Gynaecology. 2019;126(4):493-9. https://doi.org/10. 1111/
1471-0528.15475
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