Abstract :
Objective: To analyze cesarean section rates using Robsons 10 group classification system in a tertiary
hospital over a period of five years (July 2014-Dec 2018).
Main outcome: To analyze the main contributors of cesarean sections based on the ten groups under
Robsons classification and to further analyze the main indications of cesareans in the relevant groups.
Results and Discussion: All women with one or more previous cesareans with cephalic presentation
(group V) contributed to the maximum number of cesareans, (32.5%), closely followed by group I (22.86%)
and group IIA (10.25%). 31.65% of the total cesareans were elective cases, 17.23% were in women with
inductions and 51.1% of the cesareans were in spontaneously laboring women.
Robsons Ten Group Classification system (TGCS) found to be easy to understand, clear, mutually
exclusive, reproducible system for classifying cesareans in all levels of Institutions. Among women who
had elective cesareans, maximum were done in those in Group V who were not willing for TOLAC or those
who has previous two cesareans. In spontaneously laboring women, 34% were due to meconium stained
liquor and 32.9% were due to fetal distress, thus leaving a huge scope for reduction in cesarean rates.
Conclusion: All institutions should routinely monitor cesareans based on Robsons TGCS to monitor
time trends and for interinstitutional comparisons. Interventions should be targeted at maximizing normal
deliveries, reducing primary cesareans and offering TOLAC where possible. There should be institutional
protocols for defining indications like fetal distress, nonprogress of labour, failed induction and protocols
for their managements
Keyword :
Cesarean rate reductions, Robsons classification, Ten Group classification system.