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Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson
Wael Abdallah1, Georges Abi Tayeh1, Emilia Cortbaoui1
1Department of Obstetrics and Gynecology, Hôtel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon.
Insights
Cesarean section rates exceeded 50% at a Lebanese hospital, with Robson groups 5, 2, and 10 contributing most. New policies and COVID-19 restrictions in 2020 saw a decrease in cesarean sections for labor induction.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Public Health
Background:
- The cesarean section rate is a key indicator of maternal healthcare quality.
- The Robson Classification system provides a standardized method for analyzing cesarean section rates.
- Understanding cesarean section drivers is crucial for developing targeted interventions.
Purpose of the Study:
- To assess the cesarean section rate using the Robson Classification at a tertiary referral hospital in Beirut, Lebanon.
- To identify the main contributing Robson groups to the overall cesarean section rate.
- To evaluate changes in cesarean section rates following policy implementation and external factors.
Main Methods:
- A retrospective analysis of routine medical records for all live births between January 1, 2018, and September 30, 2020.
- Calculation of the overall cesarean section rate.
- Determination of the size, cesarean section rate, and absolute/relative contributions within each Robson group.
Main Results:
- The overall cesarean section rate was 56.8%.
- Robson groups 5 (single cephalic, multiparous, no scar), 2 (single cephalic, primiparous, no scar), and 10 (other cephalic, non-vertex, scar) had the highest relative contributions.
- A reduction in cesarean section rates was observed in 2020 for labor induction (groups 2 and 4), coinciding with new policies and COVID-19 pandemic restrictions.
Conclusions:
- Over half of deliveries were cesarean sections, highlighting a need for intervention.
- Implementing stricter policies to avoid unindicated primary cesarean sections is recommended.
- Enhancing awareness among practitioners and patients regarding trial of labor after cesarean section is essential.
Objective:
To evaluate the cesarean section rate using the Robson Classification for the first time in Lebanon, at Hôtel-Dieu de France University Hospital, a tertiary referral center in Beirut.
Methods:
Routine medical record data that included all live births from January 1, 2018 to September 30, 2020 was investigated. The overall cesarean section rate was recorded, and the size, cesarean section rate, and absolute and relative contributions were calculated within each group.
Results:
The overall cesarean section rate was 56.8%. The highest relative contribution to this rate came from Robson groups 5, 2 and 10, respectively. A decrease in cesarean section rate was noted in 2020 among women admitted for induction of labor (groups 2 and 4) following the implementation of new department policies and the restrictions caused by the coronavirus disease 2019 pandemic.
Conclusion:
More than 50% of the deliveries in our department were by cesarean sections (CS). Strategies to reduce this rate should include stricter departmental policies for avoidance of unindicated primary CS and raising practitioners' and patients' awareness about trial of labor after cesarean section.
