Robson classification of caesarean sections in two Polish centres on different levels of reference

Abstract

Introduction: Caesarean section (CS) is one of the most common abdominal surgeries performed in the world. The 10-Group Classification System (TGCS, Robson classification) is a World Health Organization recommended classification assessing indications based on 5 variables (parity, previous caesarean section, labour onset, foetal presentation, gestational age, and number of fetuses). The TGCS provides the opportunity to compare indications between different countries, audit, and evaluate of the quality and impact of the recommendations. Aim of the research: Classification of CS data derived from 2 centres according to the TGCS. Material and methods: We used the above-mentioned tool to classify 2000 Caesarean sections from two centres -II and III degree of reference. Results: In both groups, group 5 (RG5 -Robson group 5) constituted the largest part of all Caesarean sections, at 39.9% and 35.17%, respectively. The sum of groups from 1 to 4 (RG 1-4) had a relative contribution to the total number of Caesarean sections in individual centres of 46.94% and 53.48%, respectively. The percentage of occurrence of particular classes was similar in both centres. Conclusions:The results of our study are an attempt to determine the trend in indications for Caesarean sections according to the TGCS in Poland and to popularize the tool used according to WHO recommendations. All activities aimed at effective reduction of the number of Caesarean sections in Poland should be aimed primarily at reducing the percentage of Caesarean sections in the RG5 group. StreszczenieWprowadzenie: Cięcie cesarskie (CC) to jedna z najczęściej wykonywanych operacji brzusznych na świecie. System Robsona oparty na 10 grupach (TGCS -The 10-Group) jest klasyfikacją CC zalecaną przez Światową Organizację Zdrowia. Pacjentki klasyfikowane są na podstawie 5 zmiennych (rodność, obecność blizny po CC na macicy, rozpoczęcie porodu, położenie i liczba płodów oraz wiek ciążowy). TGCS umożliwia porównanie wskazań między różnymi krajami, audyt ośrodków oraz ocenę wpływu zaleceń. Cel pracy: Klasyfikacja CC według TGCS. Materiał i metody: Przy użyciu TGCS sklasyfikowaliśmy 2000 CC z dwóch ośrodków -II i III stopnia referencyjności. Wyniki: W obu grupach grupa 5 (RG5 -Robson group 5) stanowiła największy odsetek wszystkich CC, odpowiednio 39,9% i 35,17%. Suma grup od 1 do 4 (RG 1-4) miała względny udział w ogólnej liczbie CC w poszczególnych ośrodkach, odpowiednio 46,94% i 53,48%. Odsetek występowania poszczególnych klas był podobny w obu ośrodkach. Wnioski: Wyniki naszego badania są próbą określenia trendu wskazań do CC według TGCS w Polsce oraz popularyzacji tego narzędzia. Wszystkie działania mające na celu efektywne zmniejszanie liczby CC w Polsce powinny być ukierunkowane na zmniejszanie liczby pacjentek klasyfikowanych do grupy 5.

Using Robson classification to analyze cesarean section and induction rates in relation to changes in the standards of perinatal care in one hospital in Poland

“…In the first study from a tertiary hospital for the period 2010–2015, 34 the group R2 was considerably smaller (6.4% of the total study population) and had a considerably lower absolute CB contribution rate of 2.3%, in line with studies from Canada and Australia 30,32 . The other study analyzed CB contribution rates for Robson groups from two hospitals in Poland and reported similarly high rates for group 2 in the tertiary hospital setting 35 . Data from more hospitals in Poland are needed to examine whether the high rate of prelabor CB for nulliparous women at term is specific to Polish maternity care.…”

“…30,32 The other study analyzed CB contribution rates for Robson groups from two hospitals in Poland and reported similarly high rates for group 2 in the tertiary hospital setting. 35 Data from more hospitals in Poland are needed to examine whether the high rate of prelabor CB for nulliparous women at term is specific to Polish maternity care.…”

Spontaneous uterine rupture during pregnancy after laparoscopic myomectomy – case report

“…Most often, this complication oc-curs after a previous caesarean section (about 45%) -especially in the case of a classic uterine incision. The problem may be exacerbated by the ever-increasing rate of caesarean sections [8].…”