Evaluation of Cesarean Sections According to Robson Criteria in a Tertiary Care Center: A Cross-sectional Study

Aim and background: There are concerns all over the world about the rising rates of cesarean section (CS) both in developed and developing countries.Multiple causes have been identified worldwide for this increase, like decreasing vaginal births after cesarean deliveries, on-demand CSs due to fear of vaginal birth as well as protection from medicolegal litigations.In this study, we have tried to categorize CSs at our tertiary care center with a very high patient load, over a period of 1 year, so that factors influencing the cesareans may be appreciated and appropriate measures may be taken to reduce the rates.Materials and methods: Our objectives were to determine the CS rate using the Robson classification and to determine the absolute and relative contribution of each group under the Robson classification system.Retrospective record analysis of all the births in the Department of Obstetrics and Gynecology either vaginally or by a CS, over the period of 1 year, that is from October 2021 to September 2022.Statistical analysis: All the demographic parameters were expressed statistically as mean, median, and percentages.The CSs were grouped based on Robson's criteria and absolute and relative rates were calculated using percentages.Results: There were around 600-800 deliveries per month making a total of 9110, out of which, vaginal deliveries were 4074 (44.73%) and CSs were 5036 (55.27%).The monthly CS rate ranged from around 49 to around 61% with a mean CS rate of 55.06%.Contribution to the overall CS rate was highest from group X at 22.85% followed by group V (which includes term repeat CSs) at 20.63%.Conclusions: The need of the hour seems to be finding a balance between absolutely indicated procedures and those performed for other equally significant reasons.Clinical significance: Studies like ours, from various population groups with Robson classification of the CSs will be extremely supportive in identifying gaps, and unmet needs, and in reduction of unnecessary surgical procedures as well as increasing the rates where required.