Assessment of Caesarean Section Rates at Kathmandu Model Hospital Using the Robson's Ten Group Classification System
Rekha Poudel1, Ganesh Dangal1, Aruna Karki1
1Department of Obstetrics and Gynaecology, Kathmandu Model Hospital, Exhibition Road, Kathmandu, Nepal.
Insights
This study assessed caesarean section rates using Robson
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Surgical Outcomes
Background:
- Caesarean section rates are a key indicator of maternal healthcare quality.
- Understanding indications is crucial for optimizing delivery practices.
- Robson's Ten Group Classification System provides a standardized framework for analysis.
Purpose of the Study:
- To evaluate the caesarean section rate at Kathmandu Model Hospital.
- To identify the primary indications for caesarean sections using Robson's classification.
- To inform strategies for reducing unnecessary caesarean births.
Main Methods:
- Retrospective analysis of caesarean sections performed between January 1 and December 31, 2018.
- Classification of deliveries according to Robson's Ten Group Classification System.
- Calculation of overall caesarean section rates and group-specific contributions.
Main Results:
- The overall caesarean section rate was 66.1% (494/747 deliveries).
- Major contributors included nulliparous women in spontaneous labor (Group 1, 24.2%), those with previous caesarean sections (Group 5, 22.6%), and nulliparous women with induced labor (Group 2, 18.8%).
- Caesarean section rate among nulliparous women was 49.5%.
Conclusions:
- Interventions should target Robson Groups 1, 2, and 5 to reduce caesarean rates.
- Promoting vaginal delivery in nulliparous women is essential.
- Facilitating vaginal birth after caesarean section requires focused efforts.
Background:
Aims of this study was to assess the caesarean section rate and identify the indications contributing to the same using the Robson's Ten Group Classification System at Kathmandu Model Hospital.
Methods:
This was a retrospective study conducted at Kathmandu Model Hospital among women who underwent caesarean section from 1 January to 31 December, 2018 and were grouped according to Ten Group Classification System. The overall caesarean section rate and the contribution of each group was calculated.
Results:
The overall caesarean section rate was 66.1% (494 among 747 total deliveries) in 2018. Nullipara, singleton cephalic, >= 37 weeks, spontaneous labor (Group 1) was the major (24.2%) contributor to the overall caesarean section rate followed by previous caesarean section, singleton cephalic, >=37 weeks (Group 5, 22.6%) and nullipara, singleton cephalic, >=37 weeks, induced or caesarean section before labor (Group 2, 18.8%). Also, the caesarean section rate was 49.5% in nullipara, thus increasing the trend of caesarean section for previous caesarean section in future.
Conclusions:
Efforts must be focused more on Group 1, 2 and 5 to decrease the increasing trend of caesarean section Promoting vaginal delivery in nullipara and facilitating vaginal birth after caesarean are the most relevant areas of intervention.