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Caesarean section in Palestine using the Robson Ten Group Classification System: a population-based birth cohort
Mohammed Walid Zimmo1,2,3, Katariina Laine4,5, Sahar Hassan6
1Obstetrics Department, Al Shifa Hospital, Gaza, Palestine.
BMJ Open
|October 27, 2018
Summary
Caesarean section rates in Gaza were 22.9%, with specific groups like previous C-section mothers contributing most. Reducing primary caesarean sections in multiple pregnancies and preterm labor is key.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Caesarean section rates are a global health concern.
- The Robson Ten Group Classification System (TGCS) is a standardized tool for analyzing caesarean sections.
- Understanding caesarean section drivers is crucial for improving maternal and neonatal outcomes.
Purpose of the Study:
- To analyze the current situation of caesarean section in Palestine.
- To identify the main contributors to the overall caesarean section rate using the TGCS.
- To compare caesarean section rates across different hospitals in Gaza.
Main Methods:
- A population-based birth cohort study was conducted.
- Data were collected from obstetrical departments in three governmental hospitals in Gaza.
- 18,908 women who gave birth between January 2016 and April 2017 were included.
Main Results:
- The overall caesarean section rate was 22.9%.
- The largest contributors were multiparous women with previous C-sections (group 5, 42.6%), multiple pregnancies (group 8, 11.6%), and preterm labor (group 10, 8.1%).
- Significant differences in C-section rates were observed between hospitals for several TGCS groups.
Conclusions:
- Women in TGCS groups 5, 8, and 10 were the primary drivers of the overall caesarean section rate.
- Interventions should focus on increasing vaginal birth after caesarean section.
- Reducing primary caesarean sections for multiple pregnancies and preterm labor is recommended.
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