Robson classification: beyond caesarean rates

Background: Caesarean rates are increasing globally. Unnecessary caesarean sections are a public health concern and are associated with both short term and long-term risks. Robson’s ten group classification is the accepted classification for caesarean section and implementing it is an effective measure in understanding which group should be focussed to reduce the caesarean section rates. The classification can be used as a framework for assessing perinatal and maternal outcome. Methods: All the deliveries with gestational age more than 28 weeks at Gadag Institute of medical sciences, Karnataka, during April 2022 were included. Obstetric characteristics like parity, gestational age, previous caesarean sections, onset of labour, lie, presentation, mode of delivery, indications for caesarean section and foetal and maternal complications were recorded. Results: The caesarean rate was 57.9%. Groups 5, 1 and 2 were the major contributors. Previous LSCS was the most common indication 46%. In groups 1 to 4 foetal distress was the most common indication. The overall proportion of unfavourable foetal outcome among all deliveries was 17.7% caesarean deliveries (20.1%), vaginal deliveries 14.5%. The proportion of unfavourable maternal outcome was 1.6%; 8 women delivered by CS (2.5%) and 1 woman by vaginal delivery (0.4%). Conclusions: Caesarean section should be used appropriately and increase in caesarean section does not ensure favourable maternal or perinatal outcome.