An Observational Descriptive Study For Analysis Of Cesarean Sections According To Robson Ten Group Classification System(Rtgcs) At Kle Dr.Prabhakar Kore Charitable Hospital

Abstract

Title: Analysis of cesarean sections according to Robson’s Ten Group Classification System-An observational descriptive study. Background: In 1985,WHO stated that there is no justification for any region to have cesarean section rate higher than 15%.Optimal cesarean section rate remains a topic of controversy in both developed and developing countries. There is rise in cesarean section rate globally. Although cesarean sectionis life savingfor both mother and newborn, it carries its own maternal and perinatal morbidity and mortality in present and subsequent pregnancies.Caesarean section audits are an important tool to understand and make recommendations for a possible reduction in caesarean delivery rates. The Robson’s Ten Group Classification System is such a tool and allows auditing, analysis and comparisons of caesarean delivery rates in a standardized manner. Objective: Primary objective: To analyze the cesarean section rate in our hospital by using Robeson’s Ten Group Classification System (RTGCS). Secondary objective: To identify the leading groups contributing to high cesarean section rates using RTGCS. Methodology: This one year descriptive observational study was conducted in labour wards of Department of Obstetrics and Gynecology at teaching hospital attached to KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi during the period of January 2016- December 2016. Women who delivered with gestational age of >20 weeks were enrolled in this study.All the women were categorised according to Robsons Ten Group Classification System.Data was entered using Microsoft Excel 2010 version and analyzed using Epi-Info version 7. Data was summarized in percentages & proportions Results: A total of 6236 women were delivered during this one year period.Out of which cesarean delivery rate was 44.61%.Previous cesarean section, fetal distress and non progress of labour were the commonest indications for cesarean sections. In this study high cesarean section rate is attributed by women with previous cesarean section,single,cephalic ≥37 weeks (Group 5) i.e., 18.6%,nulliparous women single cephalic with gestational age ≥37 weeks with spontaneous labour (Group 1)i.e., 8.1% and nulliparous women single cephalic with gestational age ≥37 weeks with induction or CS before labour (Group 3) i.e.,5.5%. Conclusion: Defining an optimal cesarean section rate in our setting may not be realistic due to wide range in health status of patients.Decreasing the primary cesarean section rates is the key to reducing overall cesarean sections. TOLAC should be offered to women with previous CS after proper patient selection and counseling the pregnant women regarding its risks and benefits.