Study of Caesarean Section Births in a Tertiary Care Hospital in Mumbai Using Robson Classification System

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Surgical Outcomes

Background:

• The World Health Organization recommends the Robson ten-group classification system for monitoring cesarean section (CS) rates globally.
• This system offers a simple, robust, prospective, reproducible, and clinically relevant method for CS assessment.

Purpose of the Study:

• To classify cesarean births using the Robson classification system at a tertiary care institute.
• To identify the main contributors to high CS rates within the study population.

Main Methods:

• A prospective observational study was conducted over six months, including 4771 deliveries.
• Cesarean births were classified according to the WHO-recommended Robson classification system.
• Both live births and stillbirths meeting specific weight/gestation criteria were included.

Main Results:

• A total of 4771 deliveries occurred, with 46.76% resulting in CS.
• Robson Group 5 (women with previous CS) had the highest CS rate at 13.41%.
• Robson Groups 5, 1, and 10 were the largest contributors to the overall high CS rates.

Conclusions:

• The Robson classification system effectively identified key groups contributing to high CS rates, notably women with prior CS.
• The findings underscore the importance of providing necessary CS procedures rather than focusing on achieving arbitrary CS rate targets.