Ways to reduce the incidence of cesarean sections according to the Robson classification

Violetta Vybornykh; Nurgul Shoonaeva; Bektemir kyzy Zarema; Altynai Zhumabekova

doi:10.51248/.v43i5.3376

Authors

Violetta Vybornykh
Nurgul Shoonaeva
Bektemir kyzy Zarema
Altynai Zhumabekova

DOI:

https://doi.org/10.51248/.v43i5.3376

Keywords:

Abdominal delivery, fetal gestation, cesarean section, Robson classification, labor

Abstract

Introduction and Aim: Cesarean sections (CS) are a medically indicated and effective method for reducing maternal and perinatal mortality. The incidence of CS has increased in developed as well as developing countries over the past few decades. The objective of this study is to analyze the distribution of births according to the Robson classification and to assess ways to reduce the frequency of CS.

Methods: This is a retrospective study based on records of the delivery histories of 18,125 female patients in the maternity department of the Kyrgyz Research Center for Human Reproduction, conducted using Robson classification.

Results: However, the parameters also showed a statistically significant decrease in the highest number of patients in group 3 by -18.9% (from 40.6% to 32.9%) and group 1 by -9.9% (from 29.2% to 26.3%) in 2022 compared to 2016, p<0.001. Despite their low specific weights, the 6, 7, 8, 9, and 10 groups showed a significant increase despite their small numbers.

Conclusion: Despite their low proportion but massive increase in indicators, the small number of groups 6, 7, 8, 9, and 10 may contribute to perinatal mortality and morbidity, highlighting the need for rigorous monitoring and control of pregnant women in these groups.

Author Biographies

Violetta Vybornykh

Kyrgyz Research Center for Human Reproduction, Bishkek, Kyrgyzstan

Nurgul Shoonaeva

Kyrgyz Research Center for Human Reproduction, Bishkek, Kyrgyzstan

Bektemir kyzy Zarema

Kyrgyz Research Center for Human Reproduction, Bishkek, Kyrgyzstan

Altynai Zhumabekova

Honorary International Faculty, AJ Research Centre, AJ Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India

References

World Health Organization. Indicators to monitor maternal health goals. Available from: https://apps.who.int/iris/ bitstream/handle/10665/60261/WHO_FHE_MSM_94.14.pdf? sequence=1&isAllowed=y. Last accessed July 22, 2023.

Lebedenko, E. Yu., Bespalaya, A. V., Feoktistova, T. E., Rymashevskiy, M. A. Analysis of global trends in caesarean section levels using Robson classification. Medical Herald of the South of Russia. 2021;12(2):16-21.

Rudzevich, A. Yu., Kukarskaya, I. I., Filgus, T. A. Analysis of cesarean section rate according to the Robson classification. Modern Problems of Science and Education. 2017; 6:27171.

Hutchinson, A. M., Nagle, C., Kent, B., Bick, D., Lindberg, R. Organisational interventions designed to reduce caesarean section rates: a systematic review protocol. BMJ Open. 2018;8:e021120.

World Health Organization. WHO on caesarean section rate. Available from: https://apps.who.int/iris/bitstream/handle/ 10665/161442/WHO_RHR_15.02_eng.pdf. Last accessed July 23, 2023.

Golubev, N. A., Ogryzko, E. V., Zalevskaya, O. V., Kapustina, M. V. Morbidity and pathological conditions of pregnant women in the Russian Federation. Russian Bulletin of Obstetrician-Gynecologist. 2021; 21(3):11-19.

Robson, M. S. Classification of caesarean sections. Fetal Matern Med Rev. 2001;12(1):23-29.

Torloni, M. R., Betran, A. P., Souza, J. P., Widmer, M., Allen, T., Gulmezoglu, M., et al., Classifications for cesarean section: a systematic review. PLoS ONE. 2011;6(1):e14566.

Betran, A. P., Vindevoghel, N., Souza, J. P., Gulmezoglu, A. M., Torloni, M. R. 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.

Aisien, A. O., Oronsaye, A. U. Vaginal birth after one previous caesarean section in a tertiary institution in Nigeria. J Obstet Gynaecol. 2004;24(8):886-890.

Nakamura-Pereira, M., do Carmo Leal, M., Esteves-Pereira, A. P., Domingues, R. M., Torres, J. A., Dias, M. A., et al., Use of Robson classification to assess cesarean section rate in Brazil: the role of source of payment for childbirth. Reprod. Health. 2016;13(3):128.

Boatin, A. A., Cullinane, F., Torloni, M. R., Betrán, A. P. Audit and feedback using the Robson classification to reduce caesarean section rates: a systematic review. BJOG.2018; 125(1):36-42.

Parveen, R., Khakwani, M., Naz, A., Bhatti, R. Analysis of cesarean sections using Robson's ten group classification system. Pak J Med Sci. 2021;37(2):567-571.

World Health Organization. Robson Classification: Implementation Manual. Available from: https://apps.who.int/iris/bitstream/handle/10665/259512/9789241513197-eng.pdf. Last accessed July 22, 2023.

Shoonaeva, N. Dzh., Vybornykh, V. A. The implementation of robson classification in kyrgyzstan: the first steps. International Journal of Applied and Basic Research. 2020;4:17-21.

Guriev, D. L., Trokhanova, O. V., Gurieva, M. S., Abdullaeva, Kh. G., Kabanov, I. V., Gurieva, D. D. Applying Robson classification for the analysis of the work obstetary hospital 3 level and searching for ways to reduce frequency of the caesarean section. Mother and Baby in Kuzbass. 2018;75(4):70-74.

Robson, M. S. Can we reduce the caesarean section rate?. Best Pract Res Clin Obstet Gynaecol. 2001;15(1):179–194.

Akadri, A. A., Imaralu, J. O., Salami, O. F., Nwankpa, C. C., Adepoju, A. A. Robson classification of caesarean births: implications for reducing caesarean section rate in a private tertiary hospital in Nigeria. BMC Pregnancy Childbirth. 2023; 23(1):243.

Bhartia, A., Sen Gupta Dhar, R., Bhartia, S. Reducing caesarean section rate in an urban hospital serving women attending privately in India - a quality improvement initiative. BMC Pregnancy Childbirth. 2020;20(1):556.

Giaxi, P., Gourounti, K., Vivilaki, V., Zdanis, P., Galanos, A., Antsaklis, A., et al., Implementation of the Robson classification in Greece: A retrospective cross-sectional study. Healthcare. 2023;11(6):908.