Analysis of cesarean section causes using Robson’s Ten Group Classification System in selected hospitals affiliated to Shiraz University of Medical Sciences: a cross-sectional study

Abstract

Robson’s Ten Group Classification System [RTGCS] is widely used to evaluate, monitor, and compare cesarean delivery [CD] rates within and between delivery service centers. This study aimed to investigate the causes of CD in Shiraz teaching hospitals using RTGCS. A cross-sectional study on 1787 pregnant women who underwent CD in selected teaching hospitals in Shiraz, Iran, was selected via convenience sampling within 3 months. The data collection tool was a demographic, midwifery, and fertility information questionnaire completed through interviews and medical records. Subjects’ classification was performed based on midwifery concepts and parameters described in RTGCS. The Robson's 10-group classification is based on simple obstetrical parameters [parity, previous CS, gestational age, onset of labour, fetal presentation, and number of fetuses]. Data were analyzed using SPSS software and descriptive tests were used to describe the data. Of the 1787 subjects, 455 [25.5%] had planned CS and 1332 [74.5%] had emergency CS. The most common causes of CD were previous CD [58.6%] and fetal distress [27.6%]. Overall, 823 [46.1%] had fetal and placental causes, 1268 [71%] had uterine causes, and 78 [4.4%] had maternal causes The biggest factors that played a role in the CD rate in the present study were termed multipara women with a history of previous CD. The CD rate and the overall size of this group are still increasing, and as a result, women with a history of a previous CD must be motivated more effectively to have a vaginal birth after cesarean delivery [VBAC]