A study of caesarean section rate by using Robson's ten group classification system at tertiary care hospital, Ahmedabad, India

Background: Caesarean delivery rate is rising continuously worldwide and is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries thereby helps to optimise caesarean section rates. Methods: This study was conducted at GMERS medical college and hospital, Sola, Ahmedabad, Gujarat, India. All patients who delivered between November 2021 and May 2022, were included in the study and were classified in 10 groups according to modified Robson’s classification system. The CS rate and contribution to the overall CS rate was calculated within each group.Results: Total number of deliveries was 836, out of them 242 was CS. The CS rate was 28.94%. The main contribution to overall caesarean rate was 39.67% by group 5, followed by 17.77% by group 1, 10.33% by group 2. CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 88% in nulliparous breech (group 6), 84.95% in previous CS (group 5), 40.62% in multiparous breech (group 7) and least 3.57% in multipara spontaneous labour (group 3).Conclusions: The Robson groups 1, 2, 5 and 6 were found to be the major contributors to the overall CS rate. These groups may be targeted for effective interventions to reduce the CS rate. Reduction of primary caesarean delivery, promoting vaginal birth after CS, and careful assessment of cases before induction of labour in nulliparous women, are likely to be a few effective strategies.