Robson 10 group classification of cesarean deliveries: A cross-sectional study

Abstract

Aim and Background: Globally, the caesarean section rate is rising continuously, making it one of the most common surgical procedures. The challenge is to keep CSR low while maintaining safe outcomes for the mother and infant. The Robson’s Ten-Group Classification System (TGCS) has been praised for its simplicity, reproducibility, and flexibility and has been recommended for the monitoring CSR over time. The main aim of our study was to examine, based on the TGCS, 2000 consecutive deliveries and to identify the reasons contributing the CSR. Methods: All vaginal deliveries and Cesarean Sections (CS) performed on 2000 consecutive patients were included in a retrospective analysis. The data compiled based on Robson’s TGCS. Risk Ratios (crude RRs) with 95% confidence intervals for delivery by cesarean section were calculated for each Robson’s group and a multiple regression was conducted to identify independent predictors of CS. Results: The overall CS Rate was 51%. The largest contributions to the total CSR are Group 5 (32.2%) and Group 1 (24.7%). Robson’s group 1 had the maximum number of subjects (30.8%), of which 40.9% had CS. The second largest group of subjects were in Group 3 (24.9%), of which 19.3% underwent CS. Among the maternal characteristics, maternal age and presentation were independently associated with the mode of delivery. Conclusion: In conclusion, As per Robson’s criteria, Group 5 (previous CS) remains the main indication for CS followed by Group 1 (nulliparous in spontaneous labour). Encouraging judicious use of CS in nulliparous women and promoting vaginal delivery in those with a prior cesarean, could contribute to lowering CSR. Furthermore, Robson’s criteria can serve as an effective tool to help manage the rising global rates of cesarean sections.