ANALYSIS OF CESAREAN SECTION RATE USING THE 10-GROUP ROBSON CLASSIFICATION SYSTEM AT ABU ALI SINA TEACHING HOSPITAL

Abstract

Background: Cesarean section (CS) rate is rising worldwide including in Afghanistan. Access to CS indicates maternal quality care in a healthcare system, but higher rates are associated with increased maternal-fetal mortality due to CS severe complications. The WHO recommends the Robson classification to monitor the rational use of CS. This study aims to analyze the CS rate at Abu Ali Sina Hospital based on the 10-Group Robson classification.

Methods: This retrospective cross-sectional study was conducted at Abu Ali Sina Hospital, a tertiary care teaching hospital in Balkh, Afghanistan. The data was collected from medical documents of all women who delivered in February-March 2022. Women were classified into Robson 10 groups then the total rate of CS, absolute, and relative contribution of each group to the overall CS rate was calculated.Results: Among 2858 women delivered during the study period, 567 (19.8%) had CS. Group 5 (35.8%) was the largest contributor to the overall CS rate. 122 (61%) of women in this group had undergone pre-labor CS. Group 1 (18.5%), and Group 3 (13.2%) were the second and third largest contributors to the total CS.Conclusion: This study revealed that Group 5 was the main contributor to the overall CS. The previous CS scar was the most common indication of repeated cesarean delivery. Furthermore, high rates of CS were observed in low-risk group women. We also identified that the Robson classification can be implemented as a monitoring tool in all settings in Afghanistan even those with a lack of facilities.