Use of the Robson classification to assess, normal delivery and caesarean section trends in a Tertiary Care Hospital
Abstract
Background: Robson ten-group classification system is recommended by WHO (World health organization) as a global standard for assessment and monitoring caesarean section (CS) rates. This classification is simple and robust. It is prospective, easily reproducible and clinically relevant. The Robson classification, or Ten Group Classification System (TGCS), is a widely recognized framework for evaluating caesarean section rates and delivery trends in maternity care settings. By categorizing women into ten distinct groups based on key obstetric characteristics, the classification allows for a standardized and systematic approach to monitoring and comparing delivery practices. Objectives: The aim of the study was to evaluate the use of the Robson classification to assess, normal delivery and caesarean section trends in a tertiary care hospital. Methods: This cross-sectional observational study was conducted over one year at OGSB Hospital and Institute of Reproductive & Child Health, Dhaka, Bangladesh during January 2023 to December 2023. All pregnant women admitted for delivery at ≥28 weeks of gestation were included and categorized into ten groups according to the TGCS based on specific obstetric characteristics. Data were collected using a structured questionnaire and extracted from medical records. Descriptive statistics were used to analyze the distribution of women across the Robson groups, group-specific CS rates, and the contribution of each group to the overall CS rate. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: The group of Nullipara single cephalic ≥ 37 weeks spontaneous labor (Group 1) had 150 CS and 320 deliveries. The group size, CS rate, and absolute group contribution to overall CS were 0.41%, 0.132%, and 0.211%, respectively. Another notable category includes nulliparous women with single cephalic pregnancies at 37 weeks or more who had induced labor or a CS before labor (category 2), which accounted for 0.03% of deliveries, had a high CS rate of 0.30%, and contributed 0.23% to the total rate. Conclusion: The utility of the Robson classification in identifying areas where caesarean sections may be overused, particularly in low-risk groups, and in evaluating the effectiveness of clinical interventions aimed at promoting normal deliveries. The regular use of the Robson classification in clinical practice can provide valuable insights into delivery trends, support evidence-based decision-making, and contribute to improved maternal and neonatal outcomes in tertiary care settings.
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