The Singleton, Cephalic, Nulliparous Woman After 36 Weeks of Gestation

Brennan, Donal J.; Murphy, Martina; Robson, Michael; O’Herlihy, Colm

doi:10.1097/aog.0b013e318204521a

Cited by 73 publications

(67 citation statements)

References 19 publications

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“…Two thirds of the included studies were published in 2010 or after and presented data collected (either retrospectively or prospectively) from 1974 to 2012. The overall CS rate in the 63 articles that reported this figure ranged from 5% (1974) [20] to 53.5% (2010) [21]. Most of the studies were either cross-sectionals (40%) or trend analysis (36%) using the 10 groups over time.…”

Section: Resultsmentioning

confidence: 99%

“…However, many authors used or proposed further subclassifications in each group or merging of groups. Among the 58 studies presenting data using the classification, 34 gave data using the original 10 Robson groups with no subgrouping [9]–[12], [14], [25]–[28], [31]–[55], 18 studies presented their data using subgroups or adding new groups [13], [20], [23], [29], [30], [56]–[68] and seven studies used less than 10 groups either by focusing on only one or two groups or by combining groups [21], [22], [59], [69]–[72]. One study proposed both merging and splitting of categories [59].…”

Section: Resultsmentioning

confidence: 99%

“…While no article presented a definition of spontaneous labour, four defined induced labour [20], [30], [32], [39]. Multiple definitions were used for what is considered a “birth” and therefore which pregnant women can be included in the classification [13], [21], [23], [27], [33], [41], [45], [54], [59] (see Table 5).…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It

Vindevoghel²,

et al. 2014

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BackgroundCaesarean sections (CS) rates continue to increase worldwide without a clear understanding of the main drivers and consequences. The lack of a standardized internationally-accepted classification system to monitor and compare CS rates is one of the barriers to a better understanding of this trend. The Robson's 10-group classification is based on simple obstetrical parameters (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) and does not involve the indication for CS. This classification has become very popular over the last years in many countries. We conducted a systematic review to synthesize the experience of users on the implementation of this classification and proposed adaptations.MethodsFour electronic databases were searched. A three-step thematic synthesis approach and a qualitative metasummary method were used.Results232 unique reports were identified, 97 were selected for full-text evaluation and 73 were included. These publications reported on the use of Robson's classification in over 33 million women from 31 countries. According to users, the main strengths of the classification are its simplicity, robustness, reliability and flexibility. However, missing data, misclassification of women and lack of definition or consensus on core variables of the classification are challenges. To improve the classification for local use and to decrease heterogeneity within groups, several subdivisions in each of the 10 groups have been proposed. Group 5 (women with previous CS) received the largest number of suggestions.ConclusionsThe use of the Robson classification is increasing rapidly and spontaneously worldwide. Despite some limitations, this classification is easy to implement and interpret. Several suggested modifications could be useful to help facilities and countries as they work towards its implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It

Vindevoghel²,

et al. 2014

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“…In addition, the incidence of induction of labor varies according to different groups of women as do the indications, methods of induction, implications of inductions, and outcomes. The most significant group in this context is group 2: nulliparous women at greater or equal to 37 weeks of gestation with a single cephalic pregnancy who are induced or have a pre-labor cesarean delivery [7]. The group of women who are induced is often referred to as group 2a.…”

Section: The 10-group Classification Systemmentioning

confidence: 99%

Quality assurance: The 10‐Group Classification System (Robson classification), induction of labor, and cesarean delivery

Robson

Murphy

Byrne

2015

Intl J Gynecology & Obste

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490

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Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. It needs to be clinically relevant, robust, and prospective, and must incorporate epidemiological variables. The 10-Group Classification System (TGCS) is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. The system is demonstrated in the present paper using data for 2013 from the National Maternity Hospital in Dublin, Ireland. Interpretation of the classification can be easily taught. The standard table can provide much insight into the philosophy of care in the population of women studied and also provide information on data quality. With standardization of audit of events and outcomes, any differences in either sizes of groups, events or outcomes can be explained only by poor data collection, significant epidemiological variables, or differences in practice. In April 2015, WHO proposed that the TGCS (also known as the Robson classification) is used as a global standard for assessing, monitoring, and comparing cesarean delivery rates within and between healthcare facilities.

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“…Induction of labor grows in importance in the field of obstetrics as more and more pregnancies require inducement, particularly those associated with an unfavorable cervix [1] . Up to 50% of all labor inductions require cervical ripening, for which mechanical or chemical agents can be used [2] .…”

Section: Introductionmentioning

confidence: 99%

Cervical ripening with an osmotic dilator (Dilapan-S) in term pregnancies – An observational study

Maier¹

2015

JGNB

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Objective: The procedure of labor induction becomes increasingly important as the number of pregnancies requiring induction rises in the Western countries due to multiple reasons. In addition, a growing number of patients is aiming to achieve vaginal birth after cesarean section (VBAC). No pharmacological agent is licensed in this group of patients. A newly developed hydrophilic agent (Dilapan-S) is now available for cervical ripening, and is indicated also for patients with a previous cesarean section. Methods: Observational, non-interventional study in a tertiary perinatal center in Berlin, Germany in 2014. Eighty-three women at term with a singleton pregnancy and cephalic presentation were included. Results: In total, 60.2% of patients delivered vaginally, 4.8% by ventouse/forceps and 34.9% by secondary cesarean section. Parous women were found to have a significantly higher chance of vaginal birth (82.6% vs. 60.2% in total, p = 0.019). Patient's ≥ 35 years showed a tendency towards increased rates of ventouse and cesarean section (11.1% vs. 4.8% and 38.9% vs. 34.9% respectively). There was a tendency towards a higher rate of vaginal birth in patients with previous cesarean section (66.7% vs. 59.2%). No adverse fetal or maternal outcomes were noted. Conclusions:The application of Dilapan-S is cost-effective as patients can be seen in outpatient care. The device is efficient and safe. It is an attractive option for physicians and patients to lower the cesarean section rate by facilitating VBAC.

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The Singleton, Cephalic, Nulliparous Woman After 36 Weeks of Gestation

Abstract: III.

Cited by 73 publications

References 19 publications

A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It

A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It

Quality assurance: The 10‐Group Classification System (Robson classification), induction of labor, and cesarean delivery

Cervical ripening with an osmotic dilator (Dilapan-S) in term pregnancies – An observational study

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