Analysis of Cesarean delivery at Ain Shams Maternity Hospital Using the Ten Group Classification System

Abstract

Background: Cesarean section is an invasive surgical procedure in which a baby is delivered through an abdominal and uterine incision & carries with it many immediate and delayed morbidity and mortality risks. Objective: To evaluate the feasibility of using the Robson Ten Group Classification System (TGCS) for cesarean delivery indications at Ain Shams Maternity hospital. Methods: This is a retrospective study on women who delivered by cesarean delivery at Ain Shams Maternity hospital between July 1, 2016 and June 30, 2018. All patient files have been revised and data has been collected then categorized. The indications for this mode of delivery: suspected fetal growth impairment, fetal distress, pre-eclampsia/eclampsia, pregnancy duration in weeks or more pre-partum hemorrhage, cephalopelvic disproportion, dystocia, failure of progress, multiple pregnancy, suspected/imminent uterine rupture, breech or other malpresentations, previous cesarean delivery, failed induction of labor, tubal ligation, sterilization, maternal request genital herpes, extensive condyloma, any other obstetric complication, any other fetal indication or any other maternal medical complication. Results: 15808 women delivered in the hospital during the study period, The CS rate was 58.04%. According to the Robson classification, Group5 and Group 10 were the most represented groups (31.72% and 29.91% of population, respectively). The major contributors to the CS rate were group 5 (27.10%), group10 (14.02%).The most commonly reported indications for CS included past CS, suspected fetal distress, preeclampsia ,eclampsia.These suggested the need for further discussion on CS practices Conclusion: This study provides an example on how the WHO manual for Robson classification can be used in an action-oriented manner for developing recommendations for improving the QoC, and the quality of data collected.