Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 5 ( September-October, 2021 ) > List of Articles


Cesarean Section Rate among COVID-19 Mothers and Its Classification through Robson\'s Criteria

Ruchi Bisht, Vishakha P Kandalgaonkar, Kunaal K Shinde

Keywords : COVID-19, Cesarean section, Robson\'s criteria

Citation Information : Bisht R, Kandalgaonkar VP, Shinde KK. Cesarean Section Rate among COVID-19 Mothers and Its Classification through Robson\'s Criteria. J South Asian Feder Obs Gynae 2021; 13 (5):342-346.

DOI: 10.5005/jp-journals-10006-1921

License: CC BY-NC 4.0

Published Online: 22-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Background: The COVID-19 epidemic that erupted in November 2019 has brought medical science to the fore in news and public perceptions. As the pandemic enters the next phase with new diversity, there are various concerns regarding pregnant women, its transmission to the unborn child, and the safe and secure method of childbirth. Both the method of vaginal delivery and the delivery phase are equally appropriate. The mode of birth a woman should go through must be personal and based entirely on the severity of the disease and obstetric indications. Methods: This was a 1-year retrospective study from April 2020 to April 2021 in the Department of Obstetrics and Gynecology of the Postgraduate Institute Yashwantrao Chavan Memorial Hospital, Pimpri, Pune. All pregnant women admitted irrespective of their gestational age or whether they were in labor or not were universally screened for COVID-19. All the delivered women were segregated based on the mode of delivery, vaginal or cesarean, and the information was then classified according to Robson\'s policy. Results: The rate of cesarean section in COVID-19 patients during this 1-year period was 31.59%. Also, it was noted that the maternal mortality was more in the cases of cesarean section (1.4%) compared to vaginal delivery (0.00%). The percentage of neonates affected by COVID-19 in cesarean delivery (0.46%) was more than in vaginal delivery (0.22%). Conclusion: We conclude that there is insufficient evidence to support that the outcome of lower-segment cesarean section (LSCS) was better than vaginal delivery to prevent direct transmission from a COVID-19 pregnant mother to the neonate. The mode of delivery should be individualized and based on the severity of the disease and obstetrical indications. Therefore, in mild cases, it is advisable to continue with vaginal delivery and LSCS should be reserved for women with severe respiratory problems, where termination of pregnancy will allow for better ventilation of the newborn.

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  1. Tian H, Liu Y, Li Y, et al. An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China. Science 2020;368(6491):638–642. DOI: 10.1126/science.abb6105.
  2. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130(5):2620–2629. DOI: 10.1172/JCI137244.
  3. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395(10223): 514–523. DOI: 10.1016/S0140-6736(20)30154-9.
  4. Hoehl S, Rabenau H, Berger A, et al. Evidence of SARS-CoV-2 infection in returning travellers from Wuhan, China. N Engl J Med 2020;382(13):1278–1280. DOI: 10.1056/NEJMc2001899.
  5. Jones DS. History in a crisis – lessons for Covid-19. N Engl J Med 2020;382(18):1681–1683. DOI: 10.1056/NEJMp2004361.
  6. Liu H, Wang LL, Zhao SJ, et al. Why are pregnant women susceptible to COVID-19? An immunological viewpoint. J Reprod Immunol 2020;139:103122. DOI: 10.1016/j.jri.2020.103122.
  7. Liu Y, Chen H, Tang K, et al. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect 2020;48:436–443. DOI: 10.1016/j.jinf.2020.02.028.
  8. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: Interim guidance. Available from: 2020 [Accessed May 5, 2020].
  9. The Royal College of Obstetricians and Gynaecologists, Royal College of Midwives. Coronavirus (COVID-19) infection in pregnancy: Information for healthcare professionals. Available from: 2020 [Accessed May 5, 2020].
  10. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809–815. DOI: 10.1016/s0140-6736(20)30360-3.
  11. Liu H, Liu F, Li J, et al. Clinical and CT imaging features of the COVID-19 pneumonia: focus on pregnant women and children. J Infect 2020;80(5):e7–e13. DOI: 10.1016/j.jinf.2020.03.007.
  12. WHO statement on cesarean section rates. WHO/RHR/15.02. Available from:
  13. Lumbiganon P, Laopaiboon M, Gulmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet 2010;375(9713): 490–499. DOI: 10.1016/S0140-6736(09)61870-5.
  14. Marshall NE, Fu R, Guise JM. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011;205(3):262.e1–262.e8. DOI: 10.1016/j.ajog.2011.06.035.
  15. Souza JP, Gülmezoglu AM, Lumbiganon P, et al. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004–2008 WHO Global Survey on Maternal Perinatal Health. BMC Med 2010;8(1):71. DOI: 10.1186/1741-7015-8-71.
  16. FIGO Working Group on Challenges in Care of Mothers and Infants during Labour and Delivery Best practise advice on the 10-group classification system for caesarean deliveries. Int J Gynecol Obstet 2016;135(2);232–233. DOI: 10.1016/j.ijgo.2016.08.001.
  17. Robson M, Murphy M, Byrne F. Quality assurance: the 10-group classification system (Robson classification), induction of labour and Caesarean delivery. Int J Gynaecol Obstet 2015;131(S1):S23–S27. DOI: 10.1016/j.ijgo.2015.04.026
  18. Martin JA, Hamilton BE, Osterman MJK, et al. Births: final data for 2018. Natl Vital Stat Rep 2019;68(13):1–47. Available from: PMID: 33814033.
  19. The National Health Commission of China. Report on the development of maternal and child health in China. 2019.
  20. Della Gatta AN, Rizzo R, Pilu G, et al. COVID19 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol. 2020;223(1):36–41. DOI: 10.1016/j.ajog.2020.04.013.
  21. Breslin N, Baptiste C, Gyamfi-Bannerman C, et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM 2020;2(2):100118. DOI: 10.1016/j.ajogmf.2020.100118.
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