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Utilizing the Robson 10-Group Classification System as an Audit Tool in Assessing the Soaring Caesarean Section Rates
Oluwasomidoyin Olukemi Bello1, Adebayo Damilola Agboola1
1Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria.
Background:
The caesarean section (CS) is the most common operation performed globally with increased incidence worldwide.
Aim And Objectives:
Using the Robson 10-Group Classification System (RTGCS), we aimed to identify women who were the main contributors to the high CS rate (CSR) over a 3-year period at a foremost tertiary health facility.
Settings:
This study was conducted at the Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria.
Materials And Methods:
This study is a retrospective study of all women who delivered by CS at the University College Hospital, Ibadan, Nigeria from January 2017 to December 2019. Data were obtained using a structured proforma and women were categorized according to the RTGCS. Data were analysed using SPSS version 21. Descriptive statistics (frequency, percentage, mean) carried out were presented in tables.
Results:
The CSR was 46.9%. Women in Group 5 (parous women >37 weeks with previous CS and a single foetus in cephalic presentation), Group 1 (nulliparous women >37 weeks with a single foetus in cephalic presentation and spontaneous labour), and Group 10 (women <37 weeks with a single foetus in cephalic presentation) were major contributors to the CSR, with 30.9%, 17.7%, and 13.7%, respectively. Stillbirth rates were highest in Groups 10 (30.3%), 3 (24.4%), and 8 (16.8%). Apgar score <7 at the 5th minute was highest in Groups 5 (29.7%), 10 (17%), and 1 (16.6%).
Conclusion:
In a bid to reduce caesarean deliveries, efforts should focus on increasing the proportion of vaginal deliveries in these identified groups, especially in women with a history of one CS.
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