Patterns and indications of caesarean sections in a tertiary care hospital: a Robson Ten-Group Classification...

The study aimed to analyse the caesarean section (CS) rates in a tertiary care centre using Robson's Ten-Group Classification System (TGCS) to identify contributing factors and inform strategies for reducing CS rates.

This retrospective study was conducted at Tertiary care Hospital Pune India, during August-December 2023. Data were collected on all live and stillbirths with a birth weight ≥ 500 g or gestational age ≥ 28 weeks. CS rates were classified according to Robson's 10-group classification, and statistical analysis was performed to determine the relative contribution of each group.

The total number of deliveries was 2493, of which 1345 were CS (53.95%). The highest contribution to CS was from Group 5 (previous CS, term, cephalic), accounting for 37.92% of all CS. Group 2 (nulliparous, induced or pre-labour CS) contributed 34.42%. The lowest CS rates were seen in Groups 1 and 3 (spontaneous labour, nulliparous and multiparous). Groups 6 to 10, representing breech, multiple pregnancies, and preterm deliveries, had near 100% CS rates.

The study highlights a high CS rate, mainly due to repeat CS and induced labours. The Robson classification proved effective in identifying key groups contributing to the CS rate. Reducing unnecessary CS, promoting vaginal birth after caesarean (VBAC), and refining induction protocols could help lower CS rates. Future efforts should also focus on improving labour management and monitoring.