Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 12 , ISSUE 6 ( November-December, 2020 ) > List of Articles

Original Article

Examining the Efficacy of the Robson Classification System for Optimizing Cesarean Section Rates in South Asia

Lubna Hassan, Lauren Woodbury, Naiomi Jamal, Gehanath Baral, Jannatul Ferdous, Rubina Sohail, Shafiqa Babak, Shahanara Chowdhury, Tayyaba Wasim, Udagamage DP Ratnasiri, Attique ur Rehman

Keywords : Cesarean section rates, Cross-sectional study, Optimizing CS rates in South Asia, Robson Ten Group Classification System

Citation Information : Hassan L, Woodbury L, Jamal N, Baral G, Ferdous J, Sohail R, Babak S, Chowdhury S, Wasim T, Ratnasiri UD, ur Rehman A. Examining the Efficacy of the Robson Classification System for Optimizing Cesarean Section Rates in South Asia. J South Asian Feder Obs Gynae 2020; 12 (6):366-371.

DOI: 10.5005/jp-journals-10006-1846

License: CC BY-NC 4.0

Published Online: 12-04-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: To apply the Robson Ten Group Classification System (TGCS) in major South Asian hospitals to begin making recommendations to optimize cesarean section (CS) rates. Materials and methods: This cross-sectional study was conducted from September 2018 to February 2019 at public sector hospitals in five South Asian countries. We analyzed the pooled data for all five hospitals. The data were then stratified by the study hospitals. We utilized a Pearson χ2 test to assess differences in CS by group. And p values <0.05 were considered statistically significant. Statistical analysis was performed using STATA 16. Results: A total of 37,251 women delivered in the five participating hospitals during the 6-month study period. Of these, 13,592 women were delivered by CS with a composite CS rate of 36% (range, 22–53%). Women in groups 1, 2, and 5 were the largest contributors to the overall CS rate in the participating hospitals. Statistically significant differences in CS rates between the hospitals were found in all groups except group 9. Conclusion: TGCS is useful as a starting point with which to identify patient groups warranting interventions to optimize CS. However, data collection alone is not sufficient. Analysis and interpretation should also include assessing maternal and neonatal outcomes. Clinical significance: Preliminary findings indicate that strategies to optimize the use of CS should include avoidance of medically unnecessary primary CS and increasing vaginal birth after cesarean.

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