Evaluatıon Of Cesarean Sectıon Rates Usıng The Robson Ten-Group Classıfıcatıon: Can Cesarean Sectıon Rates Be Reduced?
Abstract
Objective: The aim of this study was to analyze cesarean deliveries performed within one year at a tertiary level maternity hospital using the Robson Ten-Group Classification System.
Material and Method: Pregnant women who were admitted to our hospital’s delivery ward and gave birth at our hospital between January 1, 2019, and December 31, 2019, without any obstetric risk factors were included in the study. The study was designed retrospectively.
Results: A total of 10,781 deliveries were included in the study. Out of these births, 4,391 were performed via cesarean section. The overall cesarean section rate among all deliveries was 40.7%. Among the women who underwent cesarean section, 9.3% were classified in the first group according to the Robson classification, while 13.6% were classified in the second group. In terms of the Robson classification, 12.1% of the women belonged to the third group, and 10.8% belonged to the fourth group. The rates of Group 5, Group 6, and Group 7 in all cesarean deliveries were 47.7%, 2.5%, and 2.6%, respectively. The rate of Group 9 among all cesarean deliveries according to the Robson classification was 1.4%.
Conclusion: In conclusion, monitoring and evaluating cesarean deliveries based on the percentages in the Robson Ten-Group Classification System form on an annual basis can contribute to reducing the cesarean section rate by enabling hospitals to prepare their own cesarean action plans and assessing their quality scores according to the determined cesarean section rate target.
References
- Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016;11(2):e0148343.
- Betran AP, Torloni MR, Zhang J, et al. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health. 2015;12:57.
- Çavlin A. Türkiye Nüfus ve Sağlık Araştırması 2018. 2019.
- Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM. WHO Statement on Caesarean Section Rates. Bjog 2016;123(5):667-670.
- Robson MS. Classification of caesarean sections. Fetal and Maternal Medicine Review 2001;12(1):23-39.
- Robson M, Hartigan L, Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol 2013;27(2):297-308.
- Robson M. The Ten Group Classification System (TGCS) - a common starting point for more detailed analysis. Bjog. 2015;122(5):701.
- WHO statement on caesarean section rates. World Health Organization; 2015.
- Souza JP, Betran AP, Dumont A, et al. A global reference for caesarean section rates (C-Model): a multicountry cross-sectional study. Bjog 2016;123(3):427-436.
- Betrán AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn’t work and how to improve it. PLoS One 2014;9(6):e97769.
- ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol 2010;116(2 Pt 1):450-463.
- Buhur A, Öncü N, Erdem D. Analysis of Caesarean Section Rates with the Robson 10 Group Classification. Turkish Journal of Health and Sport Volume. 2022;3(2):53.
- Buhur A, Erdem D. Changing trends in cesarean section deliveries in a tertiary hospital using the Robson Ten Group Classification. Journal of Contemporary Medicine. 2023;13(2):301-314.
- Altuntaş H, Dansuk R, Köse O. Sezaryen oranlarının çeşitli değişkenlere bağlı olarak değerlendirilmesi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2013;15(2):1-7.
- Devane D, Lalor JG, Daly S, McGuire W, Cuthbert A, Smith V. Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2017;1(1):Cd005122.
- Moghimi N, Vahdani-Rashvanlouyi N, Rahmani R, Farazmand T, Nezami H, Chamani V. Fetal Health Assessment by Nonstress Test and its relationship with Neonatal Hospitalization at Birth. Journal of Isfahan Medical School 2021;39(642):697-701.
- Raouf S, Sheikhan F, Hassanpour S, Bani S, Torabi R, Shamsalizadeh N. Diagnostic value of non stress test in latent phase of labor and maternal and fetal outcomes. Glob J Health Sci 2014;7(2):177-182.
- Wu JM, Hundley AF, Visco AG. Elective primary cesarean delivery: attitudes of urogynecology and maternal-fetal medicine specialists. Obstet Gynecol 2005;105(2):301-306.
- Küçük M. Defensive medicine among obstetricians and gynaecologists in Turkey. J Obstet Gynaecol 2018;38(2):200-205.
- Rauf B, Nisa M, Hassan L. External cephalic version for breech presentation at term. J Coll Physicians Surg Pak 2007;17(9):550-553.
- Shaaban MM, Sayed Ahmed WA, Khadr Z, El-Sayed HF. Obstetricians’ perspective towards cesarean section delivery based on professional level: experience from Egypt. Arch Gynecol Obstet 2012;286(2):317-323.
- Başer E, Kırmızı Aydoğan D, Özdemirci Ş, et al. An evaluation of cesarean rate in turkey by the Robson ten group classification system: How to reduce cesarean rates? Journal of Surgery and Medicine 2020;4(11):1031-1035.
Sezaryen Oranlarının Robson On Grup Sınıflandırılması İle Değerlendirilmesi: Sezeryan Oranları Azaltılabilir Mi?
Abstract
Amaç: Üçüncü basamak bir doğum hastanesinde bir yılda gerçekleşen sezaryen doğumların Robson On Gruplu Sınıflandırma Sistemi kullanılarak analiz edilmesi amaçlanmıştır.
Gereç ve Yöntem: 1 Ocak 2019 - 31 Aralık 2019 tarihleri arasında hastanemiz doğum salonuna kabul edilip, hastanemizde doğum yapmış olan ve herhangi bir obstetrik risk faktö rü olmayan gebeler çalışmaya dahil edilmiştir. Çalışmamız retrospektif olarak dizayn edilmiştir.
Bulgular: Çalışmada 10781 doğuma ait veriler incelendi. Bu doğumların 4391’i sezaryen doğum ile gerçekleşmiştir. Tüm doğumlar içerisinde sezaryen doğum oranı %40,7’dir. Sezaryen doğum yapan gebelerin %9,3’lük kısmı Robson sınıflandırmasına göre birinci grupta, %13,6’sı Robson sınıflandırılmasına göre ikinci grupta yer almıştır. Sezaryen doğum yapan gebelerin %12,1’lik kısmı Robson sınıflandırmasına göre üçüncü grupta, %10,8’i dördüncü gruptadır. Grup 5, grup 6 ve grup 7’nin tüm sezaryen doğumlardaki oranları sırasıyla % 47,7, %2,5 ve %2,6’dır. Robson sınıflandırmasına göre Grup 9 ’un tüm sezaryen doğumlar arasındaki oranı ise %1,4’tür.
Sonuç: Sonuç olarak, hastanelerin yıllık Robson On Gruplu Sınıflandırma Sistemi Formundaki yüzdelere gö re sezaryen doğumlarının izlenmesi ve değerlendirilmesi, kendi sezaryen eylem planlarını hazırlamaları ve belirledikleri sezaryen hedefine gö re kalite notlarının değerlendirilmesi de sezaryen oranının azaltılması hedefine katkı sağlayacaktır.
References
- Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016;11(2):e0148343.
- Betran AP, Torloni MR, Zhang J, et al. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health. 2015;12:57.
- Çavlin A. Türkiye Nüfus ve Sağlık Araştırması 2018. 2019.
- Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM. WHO Statement on Caesarean Section Rates. Bjog 2016;123(5):667-670.
- Robson MS. Classification of caesarean sections. Fetal and Maternal Medicine Review 2001;12(1):23-39.
- Robson M, Hartigan L, Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol 2013;27(2):297-308.
- Robson M. The Ten Group Classification System (TGCS) - a common starting point for more detailed analysis. Bjog. 2015;122(5):701.
- WHO statement on caesarean section rates. World Health Organization; 2015.
- Souza JP, Betran AP, Dumont A, et al. A global reference for caesarean section rates (C-Model): a multicountry cross-sectional study. Bjog 2016;123(3):427-436.
- Betrán AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn’t work and how to improve it. PLoS One 2014;9(6):e97769.
- ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol 2010;116(2 Pt 1):450-463.
- Buhur A, Öncü N, Erdem D. Analysis of Caesarean Section Rates with the Robson 10 Group Classification. Turkish Journal of Health and Sport Volume. 2022;3(2):53.
- Buhur A, Erdem D. Changing trends in cesarean section deliveries in a tertiary hospital using the Robson Ten Group Classification. Journal of Contemporary Medicine. 2023;13(2):301-314.
- Altuntaş H, Dansuk R, Köse O. Sezaryen oranlarının çeşitli değişkenlere bağlı olarak değerlendirilmesi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2013;15(2):1-7.
- Devane D, Lalor JG, Daly S, McGuire W, Cuthbert A, Smith V. Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2017;1(1):Cd005122.
- Moghimi N, Vahdani-Rashvanlouyi N, Rahmani R, Farazmand T, Nezami H, Chamani V. Fetal Health Assessment by Nonstress Test and its relationship with Neonatal Hospitalization at Birth. Journal of Isfahan Medical School 2021;39(642):697-701.
- Raouf S, Sheikhan F, Hassanpour S, Bani S, Torabi R, Shamsalizadeh N. Diagnostic value of non stress test in latent phase of labor and maternal and fetal outcomes. Glob J Health Sci 2014;7(2):177-182.
- Wu JM, Hundley AF, Visco AG. Elective primary cesarean delivery: attitudes of urogynecology and maternal-fetal medicine specialists. Obstet Gynecol 2005;105(2):301-306.
- Küçük M. Defensive medicine among obstetricians and gynaecologists in Turkey. J Obstet Gynaecol 2018;38(2):200-205.
- Rauf B, Nisa M, Hassan L. External cephalic version for breech presentation at term. J Coll Physicians Surg Pak 2007;17(9):550-553.
- Shaaban MM, Sayed Ahmed WA, Khadr Z, El-Sayed HF. Obstetricians’ perspective towards cesarean section delivery based on professional level: experience from Egypt. Arch Gynecol Obstet 2012;286(2):317-323.
- Başer E, Kırmızı Aydoğan D, Özdemirci Ş, et al. An evaluation of cesarean rate in turkey by the Robson ten group classification system: How to reduce cesarean rates? Journal of Surgery and Medicine 2020;4(11):1031-1035.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | October 10, 2023 |
| Submission Date | May 28, 2023 |
| Acceptance Date | August 8, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
Cite
Cited By
Distribution of Deliveries According to Robson Classification: Experiences in Tertiary Care
Türk Kadın Sağlığı ve Neonatoloji Dergisi
https://doi.org/10.46969/EZH.1445030
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