STUDY TO EXAMINE THE CAESAREAN SECTION RATES IN OBSTETRICS PRACTICE USING THE ROBSON 10 GROUPS

Abstract

Caesarean section rates seem to vary by country, within a country, type of facility and the level and type of care givers .WHO stated in 1985 that no region should exceed rates higher than 10 -15% of CS. They say that CS rates more than 15% are not associated with additional reduction in maternal and perinatal morbidity and mortality. There are a number of risks associated with CS for both mother and baby. Cost of CS is significant. ROBSON proposed a new classification system to allow critical analysis according to characteristics of pregnancy the present study aims to test the implementation of Robson 10 group classification for obstetric categories at a Medical college hospital. All obstetric information parity, mode of delivery, previous CS, indications ,gestational age ,onset of  labour, spontaneous or induced labour were evaluated .Each case was classified into one of 10 mutually exclusive category according to obstetrics characteristics. Data analysis was done and was evaluated for the distribution of cases among all 10 ROBSON classification groups. Group1  accounted for largest proportion of deliveries and 37% contribution to overall C/S rate  followed by Group 5 accounted for 87% C/S birth rate and 30% to overall contribution..  It can be concluded that proper auditing of indications of caesarean section coupled with uniform use of Robson 10 criterion universally can help us in objective assessment of rising rate of caesarean section in society in general causing great economic burden all over the world either to government or to patient’s pockets. The internal audit by using this criterion is necessary to keep caesarian rate in check.

Key words: Caesarean section (CS), Robson classification, delivery