Robson Ten Group Classification System applied to women with severe maternal morbidity

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Severe maternal morbidity poses a significant global health challenge.
• Effective classification systems are crucial for analyzing obstetric outcomes and identifying at-risk populations.
• The Robson Ten Group Classification System (RTGCS) is a standardized method for evaluating cesarean delivery (CD) and other obstetric indicators.

Purpose of the Study:

• To assess the distribution of severe maternal morbidity among women utilizing the Robson Ten Group Classification System (RTGCS).
• To identify specific Robson groups associated with higher rates of severe maternal outcomes and cesarean delivery (CD).

Main Methods:

• A secondary analysis of a multicenter, cross-sectional study involving 27 obstetric units in Brazil.
• Women with severe maternal morbidity were classified using the RTGCS.
• Cases were categorized by severity, including potentially life-threatening conditions, maternal near-miss, or death. Subgroup analyses and cesarean delivery (CD) rates were reported.

Main Results:

• Among 7,247 women with severe maternal morbidity, 73.2% underwent cesarean delivery (CD).
• Robson Group 10 (single, cephalic, preterm) was the most prevalent (33.9%).
• Groups 7 (multiparous, breech), 9 (abnormal lie, single, term), 8 (multiple births), and 10 were most associated with severe maternal outcomes. Hypertension was the most common severity condition.

Conclusions:

• The RTGCS proved valuable in analyzing severe maternal morbidity.
• The system highlighted specific Robson groups with elevated CD rates and poorer maternal outcomes.
• Findings underscore the utility of RTGCS for targeted interventions to improve maternal safety.