Cesarean Section Rate According to Robson’s Criteria- A Retrospective Analysis in a Tertiary Care Rural Centre of North India

Abstract

Introduction: The cesarean section rate has been rising over
last five decades worldwide. The reasons are electronic fetal
monitoring during labor, increasing number of pregnancies
following infertility treatment, increasing number of postcesarean
pregnancies, changing obstetrics trends regarding
vaginal breech or operative deliveries, and medicolegal
concerns. The present study analyses cesarean section rates
according to Robson’s criteria in our center.
Material and Methods: The obstetrics record of all women
admitted in the labor unit from June 2013 to May 2018 were
retrieved and analyzed based on their age, parity, gestation
age, mode of delivery and grouped according to Robson’s
classification.
Results: A total of 13392 women were delivered in the labor
unit in 5 years, during which 35.3% of patients had a cesarean
section. Among cesarean section, primary and repeat cesarean
were 57.3 and 42.7%, respectively. Most frequent indication was
fetal distress (26.7%) followed by non-progress (12.6%) and
scar tenderness (12.1%). Among primary and repeat cesareans
the commonest indications were fetal distress (38.5%) and
scar tenderness (28%), respectively. Robson’s group V had the
maximum cesarean rate (36.2%) followed by group I (16.9%)
and group II (15%). The annual trends of cesarean are almost
similar in various Robson’s categories- group I (17.3-22.5%),
group II (11.1-14%) and Group V (33.4-39.9%).
Conclusion: R obson’s g roup I , I I a nd V w ere f ound t o b e
contributing more than 50% of the cesarean section rate.
Modifiable factors for reducing cesarean rate would be to
improve successful induction of labor, decreasing primary
cesarean rate, hence the chance of repeat sections.