Analysis of caesarean section trend according to Robson's criteria in SBMCH

Abstract

Background: There has been an increase in rate of caesarean section over last five decades. This is a matter of international public health concern as it increases the caesarean section related maternal morbidity. World Health Organization proposed use of Robson Classification as a global standard for assessing, maintaining and comparing Caesarean section (CS) rates

According to WHO, Robson classification will aid in optimization of the caesarean section use, assessment of the strategies aimed to decrease the caesarean section rate and thus improve the clinical practices and quality of care in various health care facilities.

The aim of the present study was to evaluate which clinical situation contributed and led to caesarean deliveries as per Robson's classification system.

Methodology: This is a retrospective study conducted at Sree Balaji Medical College and Hospital from January 2024to June 2024.All cases delivered via caesarean section were included in the study and classified according to Robson’s classification

Results: There were a total of 481 deliveries(399 vaginal and 82 Caesarean deliveries)over the study period. The overall LSCS rate was observed to be 17%. The largest contribution was by group 5(62.2%) followed by group 2(8.5%) and group 1(7.3%).

Conclusion: Robson criteria can be used as an auditing tool for the increasing number of caesarean sections being performed. As per Robson’s criteria, group 5(previous LSCS) remains the main indication for caesarean section followed by group 2(nulliparous not in spontaneouslabor),and group1(nulliparous in spontaneous labor)respectively.Groups1and 2include caesarean sections in nulliparous women. Therefore, it is clear that increasing rates of primary caesarean sections, mainly in nullipara are responsible for the increase in caesarean section rates. Unless we reduce the rate of primary caesarean section, it may not be possible to reduce the caesarean section rate