Analyzing trends in Cesarean Section by Action Oriented Classification (Robson Criteria) at Creek General Hospital, Karachi

Objectives: The objective of this study is to analyze Cesarean section trends using the Robson classification system and identify the cause of cesarean section in each group, in a tertiary care hospital located in Karachi, Pakistan. Study Design and Settings: This cross-sectional study was conducted in the obstetric department of Creek General Hospital Karachi, from 1 Jan 2021 to 31 Dec 2022. Methodology: Data collection utilized a non-probability consecutive sampling method. This study examined the sociodemographic characteristics, indications for cesarean section, and the Robson classification system in the women who underwent cesarean section in the hospital during specified duration. Inclusion criteria of study were all women who underwent for C-section procedure during the study timeline. Data was analyzed using IBM SPSS Statistics version 26. The study adhered to the Helsinki Declaration and ethical approval. Results: The Robson classification system was analyzed in this study, and group 5 was shown to be the primary contributor followed by group 2 and then group 1. Most frequently noted indication was previous CS (43.2%), followed by non-progress of labor (15.1%), and fetal distress (11.6%). Conclusion: Cesarean section rate can be reduced by encouraging vaginal birth after cesarean section in multiparous women who had one cesarean section, under supervision of senior obstetrician. Meanwhile, the Non-progress of labor can be targeted by improving antenatal and intrapartum care, birth preparation classes and presence of companion during labor. Through CTG interpretation and their standardized management protocols will be effective in preventing and curbing the rising cesarean rate due to fetal distress