Premium
Rational dissection of a high institutional cesarean section rate: An analysis using the Robson Ten Group Classification System
Author(s) -
Tan Jarrod KH,
Tan Eng Loy,
Kanagalingan Devendra,
Tan Lay Kok
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12608
Subject(s) - medicine , singleton , vaginal birth , vaginal delivery , pregnancy , gestational age , obstetrics , parity (physics) , pediatrics , genetics , physics , particle physics , biology
Aim Cesarean section ( CS ) rates have risen far in excess of the optimal 15% recommended by the World Health Organization. The R obson T en G roup C lassification S ystem ( TGCS ) allows meaningful analysis of a CS rate. The aim of this study is to identify the leading patient categories contributing to our institution's CS rate. Methods Prospective study of all women who delivered at the S ingapore General Hospital from J anuary 2008 to D ecember 2011. The following data was recorded: parity, singleton/multiple pregnancy, previous CS , mode of labor onset and gestational age at delivery. CS rates were computed for each group, as well as their relative contribution to the overall CS rate. Results There were 6074 deliveries, in which 2011 (33.1%) women had CS delivery. Group 5 was the largest contributor to the overall CS rate (25.9%). Of the patients in this group, 18.8% had a successful vaginal birth after cesarean ( VBAC ). Group 2 was the second largest contributor to the overall CS rate at 18.0%. Group 10 had a high contribution of 16.1%. Conclusion The TGCS allows easy identification of the leading contributing patient groups. The surprisingly high contribution of group 10 suggests that our institution, a tertiary multidisciplinary teaching hospital, manages a sizeable group of high‐risk patients in its obstetric case mix accounting for the high CS rate. Almost one in five term pregnancies with one previous CS had a successful vaginal delivery, suggesting that the institutional attempted VBAC rate is higher than 20%.