Analysis of Cesarean Section rate in Minia University Maternity Hospital using Robson ten Group Classification System (A retrospective study}

Background: Cesarean section (CS) rates have increased globally and are considered an indicator of the quality of obstetric care. The Robson Ten Group Classification System (RTGCS) is a standardized tool endorsed by WHO for assessing and comparing CS rates. Objective: This study aimed to analyze CS rates over a two-year period at Minia Maternity University Hospital using the RTGCS. Methods: A retrospective cross-sectional study that was conducted from January 2022 to December 2023, including a total 8,266 women who gave birth at Minia Maternity University Hospital with a gestational age ≥ 28 weeks and/or a birth weight ≥ 1000 g. Data were extracted from hospital records, verified and coded by the researcher, then entered and analyzed using SPSS version 21. Graphics were created using Microsoft Excel. Each woman was categorized into one of the ten Robson groups based on the standard classification flowchart recommended in the Robson Manual. Quantitative data were presented as mean and standard deviation, while qualitative data were presented as frequency distribution. The association between Robson classification and maternal characteristics was assessed using Fisher’s exact test and one-way ANOVA test. Results: A total of 8,266 deliveries were analyzed. The overall CS rate was 54.4%(8,266 \ 15,182). Group 5(n=4617: multiparous women with at least one previous CS, single cephalic, ≥37 weeks) contributed the most to the overall CS rate (55.9%). Other major contributors included Group 10 (preterm, cephalic) with 22.6% and Group 2 (nulliparous, cephalic, ≥37 weeks, induced or CS before labor) with 6.1%. A significant association was observed between Robson groups and maternal characteristics such as age, parity, previous CS, and presentation (p<0.0001). Conclusion: Group 5 was the largest contributor to the high CS rate, indicating a growing trend of repeat cesareans. Efforts should focus on reducing primary CS and promoting safe vaginal birth after cesarean (VBAC). RTGCS is a useful tool for auditing and guiding obstetric practice.