CESAREAN SECTION INDICATIONS USING MODIFIED ROBSON’S CRITERIA

Abstract

Cesarean section (CS) is increasingly replacing vaginal delivery, which is concerning due to associated complications. World Health Organization (WHO) recommends robust classification such as Modified Robson's criteria for decision making to minimise non indicated CS. This study was planned to see the applicability of Modified Robson's criteria in assessing causes of CS. To classify and compare indications of CS using the WHO modified Robson’s criteria. The present study was a retrospective study conducted at Era's Lucknow Medical College over 24 months. Due approval was obtained from ethics committee before commencing the study. All cases who underwent CS from 1st January 2018 to 31st December 2019 were analysed, data classified in accordance with the WHO Modified Robson's criteria and analysed. Parameters used for analysis included gestational age, parity, number of foetuses, history of previous CS, fetal lie and presentation, induced or spontaneous labour, indication of CS and any associated high risk factors. Of 1929 deliveries, 621(32.2%) had CS. A total 500 CS were evaluated. The major contributor to overall CS rate was Group 5 [30%], 10 [17.4%] and 1 [16.4%]. Modified Robson's classification could be easily applied to our data set and helped in identification of the main groups which contributed majorly to the overall CS rate viz. previous CS, nulliparity, prematurity and induced labours. It also helped us in identifying the subgroups which require more surveillance and monitoring. It is important to focus on Group 5, 10 and 1 which constitute 63.8% of total CS being done.