Analysis of caesarean sections using robson ten group classification system at the Jos University Teaching Hospital

Abstract

Background: With Caesarean sections on the rise WHO proposes that healthcare facilities use the Robson's 10-group classification system to audit their Caesarean section rates (CSR). Hence, we sought to determine the relative contributions of each of the Robson's ten groups to the overall caesarean section rate and indications for caesarean sections in JUTH
Methods: A retrospective review of hospital records of women delivered in JUTH from January 2018 to December 2018 was performed and the Robson's ten-group classification system (RTGCS) was used to categorize women.
Results: There were 1295 deliveries over the study period of one year. The CS rate was 33.1%. According to the RTGCS, Group 5 which constituted multiparous women with previous CS with a single fetus in cephalic presentation at term (9.7%), Group 1 which constituted nulliparous women with a single fetus in cephalic presentation in spontaneous labour at term (5.7%), and Group 4 which constituted Multiparous women with a single fetus in cephalic presentation who had induction of labour or elective CS at term (3.9%) were substantial contributors to the overall CS rate. The main indications for CS were previous CS (28.7%), hypertensive disorders of pregnancy (14.0), fetal distress (11.0%), and cephalopelvic disproportion (10.3%).
Conclusion: Group 1 warrants the most attention, applying stricter criteria and due diligence in decision-making for primary CS may decrease the high CS rate and subsequently patients for Trial of labour after caesarean section (TOLAC). Proper patient selection for TOLAC will reduce the contribution from Group 5.