AN OBSERVATIONAL STUDY OF CESAREAN TRENDS AT A TEACHING HOSPITAL IN PUNJAB
DOI:
https://doi.org/10.22159/ajpcr.2021.v14i12.43264Keywords:
Caesarean section, Robson’s classification, Trial of labor after caesarean, Vaginal birth after caesareanAbstract
Objectives: The objective of the study was to study the indications and risk factors for caesarean section (CS) and to study the caesarean rates in various patient groups as per Robson’s classification.
Methods: This prospective observational study was conducted at Government Medical College Amritsar over a period of six months. All the patients admitted for delivery beyond 22 weeks were allotted to Robson groups on admission and the indications of all CS were recorded. The data collected were tabulated and analyzed statistically.
Results: There were 553 deliveries in the study period, of which there were 241 CS amounting to a caesarean rate of 43.6%. Nulliparity, previous caesarean delivery and malpresentation were significant risk factors for CS but induction of labor was not associated with increased probability of caesarean delivery. Previous caesarean delivery was the most common indication of CS followed by foetal distress. Among Robson groups, group 10 had the biggest group size and biggest contribution to cesarean rates followed by group 5.
Conclusion: Tertiary care government hospitals have a higher cesarean rates due to referral of high-risk pregnancies. Increasing the rates of trial of labour after caesarean is one of the interventions that may serve to decrease the caesarean rates in such institutions.
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References
World Health Organization. WHO Statement on Caesarean Section Rates. Geneva: World Health Organization; 2015. Available from: https://www.who.int/reproductivehealth/publications/maternal_ perinatal_health/cs-statement/en [Last accessed on 2020 Dec].
National Family Health Survey of India. National Family Health Survey 2015-16. Available from: http://rchiips.org/nfhs/NFHS-4Report.shtml [Last accessed on 2021 Jan].
World Health Organization. Robson Classification: Implementation Manual. Geneva: World Health Organization; 2017. Available from: https://www.who.int/reproductivehealth/publications/maternal_ perinatal_health/robson-classification/en [Last accessed on 2021 Jan].
Robson MS. Classification of caesarean sections. Fetal Matern Med Rev 2001;12:23-39.
Konar H, Sarkar M, Chowdhury SK. Analysis of caesarean section rates using the robson ten-group classification at a tertiary care teaching hospital in Eastern India: A cross-sectional study. J Clin Diagn Res 2021;15:QC24-8.
Jamwal D, Sharma P, Mehta A, Pannu JS. Analysis of caesarean sections using Robson’s classification system in a tertiary care centre in Northern India: An emerging concept to audit the increasing caesarean section rate. Int J Reprod Contracept Obstet Gynecol 2021;10:2281-5.
Shenoy H, Shenoy ST, Anaswara T, Remash K. Analysis of caesarean delivery using Robson ten group classification system at a tertiary care teaching institute in Kerala, India. Int J Reprod Contracept Obstet Gynecol 2019;8:1990-8.
Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: An emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynecol 2018;7:4674-7.
Mittal P, Pandey D, Suri J, Bharti R. Trend prediction for cesarean deliveries based on Robson classification system at a tertiary referral unit of North India. J Obstet Gynecol India 2019;11:1-8.
Prameela RC, Shilpa G, Farha A, Prajwal S. Analysis of cesarean section rate using Robson’s ten group classification system and comparing the trend at a tertiary hospital for 2 years. J South Asian Feder Obstet Gynaecol 2016;8:175-80.
Dar MA, Lone SA, Rashid R. Analysis of caesarean section rates by Robson’s classification. J Evid Based Med Healthc 2021;8:1460-5.
Dhodapkar SB, Bhairavi S, Daniel M, Chauhan NS, Chauhan RC. Analysis of caesarean sections according to Robson’s ten group classification system at a tertiary care teaching hospital in South India. Int J Reprod Contracept Obstet Gynecol 2015;4:745-9.
Jogia PD, Lodhiya KK. Analysis of caesarean sections according to modified Robson’s ten group classification system at a tertiary care centre in Western India. Int J Reprod Contracept Obstet Gynecol 2019;8:433-9.
Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, et al. Use of the Robson classification to assess caesarean section trends in 21 countries: A secondary analysis of two WHO multicountry surveys. Lancet Global Health 2015;3:e260-70.
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Copyright (c) 2021 Suparna Grover, Sunita Meena, Ajay Chhabra
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