Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 1 ( January-February, 2021 ) > List of Articles

ORIGINAL RESEARCH

Indication for Cesarean Section as per Robsons\'s Criteria: An Analysis of 5000 Consecutive Cesarean Cases

Anshu Baser, Sunil Sharma, Sushil Kumar, Annabelle Sabu, Akriti Gupta, Sadaf S Shaikh

Keywords : Cesarean section, Cesarean section rates, Robson\'s criteria

Citation Information : Baser A, Sharma S, Kumar S, Sabu A, Gupta A, Shaikh SS. Indication for Cesarean Section as per Robsons\'s Criteria: An Analysis of 5000 Consecutive Cesarean Cases. J South Asian Feder Obs Gynae 2021; 13 (1):22-25.

DOI: 10.5005/jp-journals-10006-1861

License: CC BY-NC 4.0

Published Online: 00-02-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: The increasing incidence of cesarean section around the world is becoming a matter of concern. Many obstetricians consider it to be the easier option as opposed to vaginal delivery. However, we must not forget that cesarean section is associated with increased morbidity to the patient. World Health Organization (WHO) in 2015 introduced Robson\'s criteria as a standardized method to determine the rate and indications of cesarean section within a healthcare facility. We here present a retrospective analysis of 5000 cesarean sections by Robson\'s criteria. Aim and objective: This study aims to analyze the indications for cesarean section at a tertiary care center. We also aim to determine whether Robson\'s classification can be used as an effective auditing tool to classify and collect data regarding cesarean sections. Materials and methods: A retrospective analysis of a total of 5000 lower segment cesarean section (LSCS) as per Robson criteria was carried out at MGM Hospital, Kalamboli from January 1, 2015 to December 30, 2019. The indications for LSCS and the maternal and fetal complications were noted. Results: The overall cesarean section rate during the study period was 28%. Out of the 5000 study population, 32.7% comprised of group 5 (previous cesarean section) of Robson\'s classification followed by 23.04% in group 2 (labor induced or LSCS before labor starts). Conclusion: Robson criteria can be used as an auditing tool for the increasing number of cesarean sections being performed around the world. As per Robson\'s criteria, group 5 (previous LSCS) remains the main indication for cesarean section (33%) followed by group 2 (nulliparous not in spontaneous labor) (23%), and group 1 (nulliparous in spontaneous labor) (17%), respectively. Groups 1 and 2 indicate cesarean sections in nulliparous women. Therefore, it is clear that increasing rates of primary cesarean sections, mainly in nullipara are responsible for the increase in cesarean section rates. Unless we reduce the rate of primary cesarean section, it may not be possible to reduce the cesarean section rate. Clinical significance: Cesarean sections are increasing worldwide. WHO recommends an ideal rate of 10–15%. If we can determine the indications of the cesarean section we can aim to reduce the cesarean section rate by reducing the primary indication itself. This in turn can help in reducing the morbidity and mortality associated with cesarean sections. Robson\'s criteria can be used as an effective tool due to its simplicity to classify these indications.


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