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Use of the Robson Ten Group Classification System to categorise operative vaginal delivery
Bobby D O'Leary1, Daniel T Kane1, Nicholas Kruseman Aretz1
1Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin 1, Ireland.
Summary
Operative vaginal delivery (OVD) is common in Ireland, particularly for nulliparous women. The Robson Ten Group Classification System (TGCS) can help identify groups for interventions to reduce OVD rates.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Operative vaginal delivery (OVD), including vacuum or forceps-assisted births, is used to expedite vaginal delivery.
- While OVD rates are declining globally, they remain high in Ireland.
- No standardized system currently exists for analyzing OVD rates, unlike caesarean delivery rates.
Purpose of the Study:
- To analyze operative vaginal delivery (OVD) rates using the Robson Ten Group Classification System (TGCS).
- To identify specific patient groups contributing significantly to the overall OVD rate.
- To provide a framework for comparing OVD rates across institutions.
Main Methods:
- Retrospective cohort study of 86,191 deliveries at a Dublin tertiary university institution (2007-2016).
- Extraction of delivery mode from hospital records.
- Analysis of OVD rates categorized by the Robson TGCS.
Main Results:
- Operative vaginal delivery (OVD) accounted for 19.3% of all deliveries.
- Nulliparous women with singleton, cephalic fetuses in spontaneous labor (Robson Group 1) represented 46.1% of all OVDs.
- Induced nulliparous women (Group 2) had higher OVD rates than spontaneous laboring nulliparous women (Group 1).
Conclusions:
- Operative vaginal delivery (OVD) constitutes nearly one in five deliveries, primarily in nulliparous women.
- Targeted interventions in specific nulliparous groups could potentially lower OVD rates.
- The Robson TGCS offers a valuable, accessible tool for hospitals to monitor and compare OVD rates.
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