Mudasir Ahmad Dar1, Sameer Ahmed Lone2, Rehana Rashid3
BACKGROUND
A standard and comprehensive classification system is needed to maintain
appropriate Caesarean section (CS) rates like Robson Ten Group Classification
System. The present study was conducted to analyse Caesarean section rate and
its distribution according to Robson’s classification.
METHODS
A descriptive study was conducted in the Department of Obstetrics and
Gynaecology, Deen Dayal Upadhyay Hospital, Hari Nagar, New Delhi, from August
2018 to May 2019 on pregnant women of more than 28 weeks of gestation
admitted for delivery.
RESULTS
Out of 8099 deliveries, 2924 required Caesarean section. The overall Caesarean
section rate was 36.11 %, 1616 (55.27 %) were primary Caesarean section and
1308 (44.73 %) were repeat Caesarean section. Preterm delivery by Caesarean
section was in 7.49 %. Majority of Caesarean section were in 37- 40 weeks of
gestation (79.42 %). Out of 2924 cases 90.62 %, 8.21 % and 1.17 % were
cephalic presentation, breech and other presentations respectively. 32 Caesarean
section cases were twin pregnancy, 20.83 % was induced whereas 23.91 % was
in spontaneous labour. Previous Caesarean section (44.74 %) was the commonest
cause followed by foetal distress (16.82 %). Commonest cause for repeat
Caesarean section was foetal distress (25.76 %). Major contributor to overall
Caesarean section rate was Robson’s group 5 (38.72 %) followed by group 2 and
group 1 i.e 21.64 % and 11.79 % respectively. Least contributor was group 8 (1.09
%).
CONCLUSIONS
Robson’s classification can help to identify broad categories of women to be
targeted to decrease Caesarean section rates. Caesarean section rate can be
reduced by decreasing primary Caesarean section, offering trial of labour (TOLAC),
strict induction protocols implementation and precise interpretation of foetal heart
rate tracings.
