Skip to main content
SpringerLink
Log in

Study of Caesarean Section Births in a Tertiary Care Hospital in Mumbai Using Robson Classification System

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Introduction

Robson ten-group classification system is recommended by WHO (World health organization) as a global standard for assessment and monitoring caesarean section (CS) rates. This classification is simple and robust. It is prospective, easily reproducible and clinically relevant.

Methodology

We conducted a prospective observational study of CS births at a tertiary care institute. Caesarean births in a tertiary care hospital were classified using Robson classification system as recommended by WHO. The study was conducted for period of 6 months duration. The ethics committee of the institute approved this study. We enrolled 4771 consecutive women who delivered during this study period. We included patients who had vaginal delivery as well as those who had delivery by CS. Both live births and stillbirths (of at least 500-g birth weight or at least 22 weeks gestation (according to WHO recommendations) were included in this study.

Results

During this study period, we had 4771 deliveries, out of which 2231 pregnant women (46.76%) were delivered by CS as compared to 2540 vaginal deliveries. Women with previous CS (term with single cephalic pregnancy) were included in Robson group 5. Group 5 had the highest CS rate (13.41%). Robson group 5, 1 and 10 were the largest contributors to the high CS rates at our institute.

Conclusion

In our study, 4771 deliveries were conducted during this study period (6 months). Out of 4771 deliveries, CS was done in 2231 pregnant women (46.76%). 2540 women had vaginal deliveries. Group 5 (13.41%) which comprised of women with previous CS had the highest CS rate followed by group 1 and group 10. The second largest contribution was from Group 1 with CS rate of 9.01%. Robson Group 1 included nulliparous term women with single cephalic pregnancy in spontaneous labour. Group 10 was the third largest contributor to the overall CS. Group 10 included women who delivered preterm (single cephalic presentation). Group 10 contributed to 8.09% of overall CS rate. We should make every effort to provide CS for women requiring this procedure, rather than work towards achieving a specific rate for CS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Mahadik K. Rising cesarean rates: are primary sections overused? J Obstet Gynaecol India. 2019;69(6):483–9. https://doi.org/10.1007/s13224-019-01246-y.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Singh A, Malik R. Changing trends and determinants of caesarean section using robson criteria in a government tertiary level hospital. Int J Reprod Contracept Obstet Gynecol. 2021;10:1066–72.

    Article  Google Scholar 

  3. Robson classification: implementation manual by WHO dated 26 November 2017 https://www.who.int/publications/i/item/9789241513197

  4. Gomathy E, Radhika K, Kondareddy T. Use of the Robson classification to assess caesarean section trends in tertiary hospital. Int J Reprod Contracept Obstet Gynecol. 2018;7:1796–800.

    Article  Google Scholar 

  5. Leno DWA, Bah ME, Moumbagna JC, Millimouno TM, Lamah D, Delamou A, et al. Evaluation of caesarean section practices according to Robsonʼs 10-group classification at a level two maternity ward in Conakry, Guinea. Int J Reprod Contracept Obstet Gynecol. 2019;8:4468–73.

    Article  Google Scholar 

  6. Gadappa S, Gemavat H, Deshpande S, Shah A. Interventions to reduce caesarean section rates at government medical college and hospital Aurangabad, India. Int J Reprod Contracept Obstet Gynecol. 2020;9:1563. https://doi.org/10.18203/2320-1770.ijrcog20201224.

    Article  Google Scholar 

  7. Das V, Kumar N, Kumari V, Agarwal A, Pandey A, Agrawal S. Increasing rates of cesarean section, an upcoming public health problem: an audit of cesarean section in a tertiary care center of North India based on Robson classification. Int J Reprod Contracept Obstet Gynecol. 2017;6:4998–5002.

    Article  Google Scholar 

  8. Patra K, Chattopadhyay S, Samanta P, Mondal C. A retrospective analytical study of caesarean section in intrauterine foetal death cases in a rural medical college. Int J Reprod Contracept Obstet Gynecol. 2018;7:2583–5.

    Article  Google Scholar 

  9. Ray A, Jose S. Analysis of caesarean-section rates according to Robsonʼs ten group classification system and evaluating the indications within the groups. Int J Reprod Contracept Obstet Gynecol. 2017;6:447–51.

    Article  Google Scholar 

  10. Bhatt M, Kadikar G, Parmar DC, Kanani M. Retrospective study of cesarean section by using the Robson’s ten group classification system. Int J Reprod Contracept Obstet Gynecol. 2018;7:1054–7.

    Article  Google Scholar 

  11. Wahane A, Ghaisas AS. Analysis of caesarean sections according to Robson’s criteria at a tertiary care teaching hospital in central India. Int J Reprod Contracept Obstet Gynecol. 2020;9:4221–6.

    Article  Google Scholar 

  12. Heera ST, Shenoy ST, Anaswara T, Remash K. Analysis of caesarean delivery using Robson ten group classification system at a tertiary care teaching institute in Kerala, India. Int J Reprod Contracept Obstet Gynecol. 2019;8:1990. https://doi.org/10.18203/2320-1770.ijrcog20191956.

    Article  Google Scholar 

  13. Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynecol. 2018;7:4674–7.

    Article  Google Scholar 

  14. Yerra AK, Khan MI. Analysing trends in caesarean sections at a tertiary care teaching hospital in South India: findings from a clinical audit using Robson criteria. Int J Reprod Contracept Obstet Gynecol. 2020;9:1463–9.

    Article  Google Scholar 

  15. Patel MK, Prajapati SM. A study of cesarean section rate by using modified Robsonʼs ten group classification system. Int J Reprod Contracept Obstet Gynecol. 2019;8:2610–6.

    Article  Google Scholar 

  16. Tura AK, Pijpers O, de Man M, et al. Analysis of caesarean sections using Robson 10-group classification system in a university hospital in eastern Ethiopia: a crosssectional study. BMJ Open. 2018;8: e020520. https://doi.org/10.1136/bmjopen-2017-020520.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gautam P, Karki C, Adhikari A. Robsonʼs group 2 criteria among total caesarean sections in a Tertiary Care Hospital: a descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2021;59(243):1098–101. https://doi.org/10.31729/jnma.7138.PMID:35199745;PMCID:PMC9124328.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 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):567–71. https://doi.org/10.12669/pjms.37.2.3823.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Trojano G, Damiani GR, Olivieri C, Villa M, Malvasi A, Alfonso R, Loverro M, Cicinelli E. VBAC: antenatal predictors of success. Acta Biomed. 2019;90(3):300–9. https://doi.org/10.23750/abm.v90i3.7623.PMID:31580319;PMCID:PMC7233729.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funding has been received.

Author information

Authors and Affiliations

  1. Department of OBGY, LTMMC, Mumbai, Maharashtra, India

    Hitendrasing Rajput M.S. (OBGY), MBBS, Pradnya Changede MS (OBGY), FICOG, FCPS, DGO, MBBS, IBCLC, Niranjan Chavan MD (OBGY), MICOG, FCPS, DGO, DFP, MBBS, Arun Nayak MD (OBGY), FICOG, FAMS, FCPS, DGO, MBBS,  Shikhanshi MS (OBGY), MBBS, Hera Mirza MS (OBGY), MBBS & Shalini Mahapatra MS (OBGY), MBBS

Authors
  1. Hitendrasing Rajput M.S. (OBGY), MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pradnya Changede MS (OBGY), FICOG, FCPS, DGO, MBBS, IBCLC
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Niranjan Chavan MD (OBGY), MICOG, FCPS, DGO, DFP, MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arun Nayak MD (OBGY), FICOG, FAMS, FCPS, DGO, MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shikhanshi MS (OBGY), MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hera Mirza MS (OBGY), MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shalini Mahapatra MS (OBGY), MBBS
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Authors have contributed to the design, data collection, data analysis, writing and proof reading of manuscript.

Corresponding author

Correspondence to Pradnya Changede MS (OBGY), FICOG, FCPS, DGO, MBBS, IBCLC.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Permission

Taken from institutional ethics committee.

Informed Consent

Informed consent has been obtained from all participants of this study.

Research Involving Human Participants

Study has been approved by institutional ethics board and all procedures performed in study involving human participants were in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Hitendrasing Rajput (MS (OBGY), MBBS) is a Postgraduate, Pradnya Changede (MS (OBGY), FICOG, FCPS, DGO, MBBS, IBCLC) is a Associate Professor, Niranjan Chavan (MD (OBGY), MICOG, FCPS, DGO, DFP, MBBS) is a Professor and Head of Unit, Arun Nayak (MD (OBGY), FICOG, FAMS, FCPS, DGO, MBBS) is a Professor and Head of Department, Shikhanshi (MS (OBGY), MBBS) is a Postgraduate, Hera Mirza (MS (OBGY), MBBS) is a Postgraduate, Shalini Mahapatra (MS (OBGY), MBBS) is a Postgraduate.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rajput, H., Changede, P., Chavan, N. et al. Study of Caesarean Section Births in a Tertiary Care Hospital in Mumbai Using Robson Classification System. J Obstet Gynecol India 73, 496–503 (2023). https://doi.org/10.1007/s13224-023-01851-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-023-01851-y

Keywords

Search

Navigation