Cesarean delivery on maternal request and Robson classification

To describe the types of cesarean delivery on maternal request (CDMR), and to analyze the distribution of delivering types according to the Robson Classification (RC) and the distribution of comorbidities among the different groups of delivering types.

Cross-sectional study using electronic records of deliveries that occurred in a public, academic high-risk maternity hospital in Brazil, from October 2017 to October 2021. CDMR included first or second cesarean delivery (CD), subdived into three groups: elective (CDMRele), induction withdrawal (CDMRiw), and labor withdrawal (CDMRlw).

In 7779 deliveries, 53.1% (4132) were CD. The CDMR group corresponded to 10.2% (420/4132) of all CD and 5.4% (420/7779) of all deliveries. CDMRele were the main group (246 - 58.6%), followed by CDMRiw (118 - 28.1%), and CDMRlw (56 - 13.3%). The CDMR and its subdivisions were concentrated in RC group 5.1 (CDMR 240 - 57.1%, CDMRele 156 - 63.4%, CDMRiw 54 - 45.7% and CDMRlw 30 - 53.6%). Second CD corresponded to 3.1% (247/7779) of all deliveries and 58.8% (247/420) of CDRM. Among CDMR, 72.1% (303/420) of patients had comorbidities and the most frequent diseases were hypertension and diabetes.

The definition of CDRM in the international literature is not a consensus and Brazil's law supports CDMR in circumstances not previously described. The RC is limited for understanding the growing phenomenon of CDMR among a group of pregnant women with high prevalence of comorbidities.