Analysis of Cesarean Section Using Robson’s 10-Group Classification at a Tertiary Level Hospital in Nepal (original) (raw)
Related papers
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Caesarean sections are effective in saving maternal and infant lives, but only when they are performed for medically indicated reasons, The Objective of this study was to reduce caesarean Section rate at GMCH, Aurangabad and to improve overall birthing experience with respectful maternity care.Methods: The caesarean sections done at GMCH Aurangabad were audited using Robson`s Ten Group classification system to identify the major contributors to the overall CS rate. The following clinical and non-clinical interventions were applied dynamically to control the caesarean section rates. Clinical Interventions were changes in protocols regarding induction of labour, Intermittent auscultation as opposed to continuous electronic foetal monitoring in low risk cases, use of a partogram, encouragement of different birthing positions, promoting TOLAC to reduce the secondary CS rate. Nonclinical interventions include encouragement of DOULA (birth companion), ante-natal counselling of...
2020
In 1985, World health organization has recommended that CS rates should not be more than 15%, as CS rates above this, are not associated with additional reduction in maternal neonatal mortality and morbidity. As with any surgery, CSs are associated with short-term and longterm risk which can extend many years beyond the current delivery and affect the health of the woman, her child, and future pregnancies. But over these last 3 decades, there has been a clear evidence of benefits vs risks of CS and marked improvements in the clinical obstetrics care outcomes have been observed. In view of this, there had been rising demand by the clinicians and health care policy makers to revisit the existing recommended rate proposed in 1985.
Caesarean Section -Incidence, Indications and Outcome at Tertiary Care Hospital
2019
Original Research Article Introduction: Caesarean section (CS) rates have been increasing worldwide and have caused concerns. For meaningful comparisons to be made, World Health Organization recommends the use of the Ten-Group Robson classification as the global standard for assessing CS rates. Objectives: To find out the incidence, indications for CSection (Robsons’s classification) and associated maternal& perinatal outcome. Methods: A prospective longitudinal study of 2 years period from 1 st September 2017 to 30 August 2019 .One thousand cases of cesarean sections performed at Rural Medical College , Loni were compiled using Robsons’s classification and analyzed. Results: Out of total 19,566 deliveries, 6093 were total caesarean sections of which 4108 were primary caesarean sections,resulting in overall rate of caesarean section of 31% and that of primary caesarean section of 21%.Previous LSCS (32.1%),Preeclampsia (10.8%), CPD (9.6%), and Breech (6.2%) were the common indication...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: High caesarean section rate worldwide including India is matter of concern. The aim of this study is to analyse caesarean section rate at tertiary care centre according to Modified Robson’s classification.Methods: This retrospective study was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIMHS) and Shri Mahant Indiresh Hospital at Dehradun from April 2018 to September 2018. All women delivered during this period were classified according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its contribution to overall caesarean section rate.Results: Out of total 1302 women delivered, 395 underwent CS (30.3%).The major contribution to overall caesarean section rate was 33.4% by group 5 (Previous CS, singleton, cephalic, >37weeks) followed by 16.7% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015
Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate. Methods: This retrospective study was conducted at Pondicherry Institute of Medical Sciences (PIMS), a tertiary care teaching hospital in Puducherry, South India. The data was collected for the women delivered by CS during January 2011 to December 2011 and proportions in various groups as per Robson's ten-group classification system were calculated. Results: Among a total of 1123 women delivered during study period, 367 (32.6%) delivered by CS. The CS rates among various groups varied from 100% among women with breach presentation (group 6 and group 7) and abnormal lies (group 9) to 5.9% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with precious section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.1%) to the total number of CS. Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.
The Rate and Indication of Caesarean Section in a Tertiary Care Centre
2020
Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births. Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%). Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased ...
Outcome in women with previous caesarean section in a secondary care hospital in rural South India
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Caesarean section has become increasingly the common method of delivery. From 1980 to 2001 the rate in UK has increased from 9% to 21% of all births. The aim of the study was to find out the outcome of delivery in women with previous cesarean section, the mode of delivery, maternal and fetal outcome of labour and various factors which influence the mode of delivery. Methods: 150 women with one previous caesarean section who attended the antenatal clinic and fit the inclusion criteria were enrolled in the study. Results: Success rate of VBAC was 30.5% among those included in trial of labour after caesarean section (TOLAC). 60.7% of the enrolled women underwent elective repeat caesarean section of which 54.9% were at the patients' request. Favorable Bishop's score (p= 0.0002) and previous cesarean section for breech (p=0.191) are positively associated with VBAC. Incidence of maternal complications in the study was 10.67% and 2.5% babies had an Apgar <7 at 5 minutes. There was no maternal or neonatal mortality. Conclusions: The VBAC rate in the study is 30.5% in carefully selected patients for trial of scar with the existing litigation pressure. TOLAC can be judiciously implemented in carefully chosen patients even in rural health setting equipped with required facilities. Patient's participation in the decision making has brought down the VBAC rate which is reflected by the increased repeat elective cesarean section done at patients' request (54.9%). Factors such as prior vaginal delivery, favorability of the cervix, indication of previous cesarean section, onset of labour and birth weight are highly significant in deciding the success of VBAC and can be used to improve VBAC rates in practice.
2020
Introduction : Despite the lack of scientific evidence indicating any substantial maternal and perinatal benefits from increasing caesarean section rates, most of the studies are showing that higher rates could be linked to negative consequences in maternal and child health, still caesarean rates continues to increase worldwide, particularly in middle and high income countries, and have become a major and controversial public health concern. Therefore, we conducted this study to analyse the LSCS rate in the institute, to classify the indications of LSCS as per RTGCS and to find out strategy to decrease the prevalence of lower segment caesarean section. Material & Methods : This is a retrospective hospital based study at tertiary care centre. Data collection of one thousand pregnant females who delivered by caesarean section from the period of January 2018 onwards was assessed for the study. There are six parameters as per Robson’s classification to classify all pregnant females for ...
Analysis of current trends in caesarean section in a tertiary care hospital
IP Innovative Publication Pvt. Ltd, 2017
In the background of increasing rates of caesarean sections, this study was done to find the current trends of the surgery. Aim: To study 500 consecutive caesarean sections in a tertiary referral maternity hospital in South India to understand the current trends in caesarean. Objective: 1. To find out the incidence of caesarean sections and the pattern of the indications 2. To find the pattern of age distribution, parity, period of gestation, intra operative & post operative complications, fetal & maternal outcome in caesarean sections & 3. To compare elective and emergency caesarean sections Method: This was a prospective study carried out in a District Maternity hospital in South India. We included 500 consecutive caesarean sections from the time of commencement of the study. The various characteristics of the patient & newborn profile, the surgical indications & complications were noted and compared in elective & emergency caesarean sections & the statistical significance was noted by applying Chi square test. Results: The incidence of caesarean section was found to be 30.1% in our study. Of the total 500 cases studies, 68.2% were emergency sections. Most elective cases were in parous women (69.1%); whereas most emergency cases were in nulliparous women (68.03%). Commonest indication for caesarean section was previous caesarean section in the elective group; while in the emergency group, it was meconium and fetal distress. Intra operative complications and perinatal mortality were significantly more in emergency cases. Post operative morbidity was seen in 16.2% cases. Conclusion: There is a need to avoid unwarranted surgeries, mainly primary caesarean section and also the need to give trial of scar in carefully selected cases so that the caesarean rate stabilizes with good maternal and fetal outcome.