R. Srividhya1, K. Jhansi Rani2
BACKGROUND
In current and subsequent births, Caesarean sections bear their own risks for
maternal and perinatal morbidity and mortality. In contrast with vaginal delivery,
Caesarean section has increased risk of blood transfusion, hysterectomy and death
and the risk of uterine rupture, placenta accreta and placenta previa in future
pregnancies is also increased. We wanted to analyse the Caesarean section rate
using Robson ten group classification system & identify the leading groups
contributing to high caesarean section rates using Robson ten group classification
system.
METHODS
This observational descriptive study enrolled 11,090 women who underwent
delivery, of whom 5117 (46.14 %) women delivered vaginally and 5973 (53.86
%) women delivered through Caesarean section.
RESULTS
Overall caesarean section percentage was 53.86 %. Major contributors for the CSR
were Group 5, 2 and 1 in that order. CS rate in Group 5 and 1 is relatively
increased. Ratio of relative size of Group 1 and 2 is 1:2 indicating a greater number
of prelabour caesarean sections in nulliparous women. Caesarean section rate in
Group 1 and 2 was 15.7 % and 20.1 % respectively. The main indications for
caesarean sections being fetal distress, non-progressive labour and severe
oligohydramnios / anamnios. Relative size of Group 1 and 5 was 47.3 % stating
that most of the obstetric population was in Group 1 and 5. Caesarean section rate
in Group 3 and Group 4 was relatively higher than expected; this may be due to
our institute being a referral center. Group 5 contributed 45.7 % to overall
caesarean section rate.
CONCLUSIONS
Standardisation of indication of Caesarean deliveries, regular audits and definite
protocols in hospital will aid in decreasing the Caesarean section rate in hospital.
