Evaluating the Rates of Caesarean Section Rates Using the Robson Classification in a Tertiary Care Center

Abstract

Background: Caesarean section (CS) rates have been increasing globally, raising concerns regarding unnecessary procedures and their associated maternal and neonatal risks. The Robson Ten-Group Classification System (TGCS) is a standardized and widely accepted tool used to evaluate, monitor, and compare CS rates across healthcare institutions.

Methods: This retrospective observational study was conducted over a three-year period at a tertiary care center. Obstetric data were obtained from computerized hospital records. All women admitted for delivery were classified into one of the ten Robson groups based on parity, previous CS, gestational age, onset of labour, fetal presentation, fetal lie, and number of fetuses. Group size, group-specific CS rates, and contributions to the overall CS rate were analyzed. The study aimed to identify the major contributors to the overall CS rate using the Robson TGCS.

Results: During the study period, 5,493 deliveries were recorded, including 2,649 caesarean sections, resulting in an overall CS rate of 48.22%. Group 1 constituted the largest proportion of the obstetric population, followed by Groups 2 and 5. Group 5 was the leading contributor to the overall CS rate, followed by Groups 2 and 1. Very high group-specific CS rates were observed in Groups 5, 6, 7, 9, and 10. Collectively, Groups 1, 2, and 5 accounted for the majority of all caesarean deliveries.

Conclusion: The Robson TGCS is a practical and effective tool for auditing and evaluating caesarean section practices. Strategies focused on reducing primary caesarean sections, optimizing labour induction practices, and promoting appropriate vaginal birth after caesarean (VBAC) may help improve and rationalize CS rates.