Evaluation of the indication of Cesearean section delivery in a tertiary care centre in eastern India using Robson classification

Abstract

Background: Rates of caesarean section (CS) has increased almost 10% more than the recommended rate by WHO. Although lifesaving during threatening pregnancy complications, overuse of CS without proper obstetric care brings increased medical risks especially in low income countries. In lieu of increasing CS rates standard classification systems including Robson’s classification were introduced for informed action to perform CS. Aims & Objectives: The objective of current study is to analyse CS rates in a tertiary care centre according to Modified Robson’s ten group’s classification so as to make informed decisions in choice of mode of delivery. Methods: A prospective observational cross-sectional study was carried out in a tertiary centre in Kolkata, India from the period Feb 2020 to Sept 2021 to understand the major indication of CS in a tertiary care centre of a low income country. Results: 500 women with gestational age greater than 28 weeks and mean age 27.896 ± 5.78 years who underwent CS were recruited in the study. Majority (63.6%) of the CS were emergency. In total, the present study observed that group 5 (36.6%), 2 (21.2%) and 1 (16%) were the major contributor for CS. Conclusions: The results of the study are in alignment with similar studies from other regions. Group -5 (cephalic presentation at term with previous uterine scar) being the major cause of increase in CS rate, more studies should be conducted on safety of Trial of labour after caesarean (TOLAC).