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2019 Month : November Volume : 8 Issue : 44 Page : 3292-3296

Retrospective Evaluation of Caesarean Section by Robsons Ten Group Classification System (RTGC) System in a Tertiary Care Hospital.

Sangita Patra1, Jhantu Kumar Saha2, Pallab Kumar Mistri3

Corresponding Author:
Dr. Jhantu Kumar Saha,
Snehanil Apartment, Flat No. 2B,
124, Prince Golam Hossain Shah Road,
Jadavpur, Kolkata-700032,
West Bengal, India.
E-mail: patra_sangita@yahoo.co.in

ABSTRACT

BACKGROUND

It is noticed that caesarean section (CS) rates are rising worldwide.(1) Robson, proposed a new classification system, the Robson’s Ten-Group Classification System to allow critical analysis according to characteristics of pregnancy. WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-section rates. The study was done to determine the relative size of each group of RTGC system, the CS rate in each group and percentage of contribution of CS by each group to the overall CS rate.

METHODS

It was a retrospective study conducted at MCH, Kolkata. All the women who delivered between Jan 2016 and Dec 2016 were included. All relevant obstetric parameters were collected from the logbook in the records section and were entered in Microsoft Excel and analysed.

RESULTS

Group 1 was the largest (26.08%) followed by group 3 (23.34%) and 5 (19.04%). Group 10 had the smallest relative size (1.24%). CS rate was highest in group 9 (100%) followed by group 5 (92.8%).This group had the highest (17.66%) contribution to the overall CS rate followed by group 1. (11.5%). The” composite model” revealed: NPOL (Non-Progress of Labour) was the most common indication for CS in group 1. Caesarean section rate was the highest (23.21%) for primary/secondary infertility, elderly primi etc. in group 2. PIH (Pregnancy Induced Hypertension) was the most common indication in group 3, 4, 7 and 8 undergoing CS. Group 5 had highest CS rate for post caesarean pregnancy in labour. Primi breech per se was the most common indication for CS in Group 6. Scar tenderness had the highest CS rate (14.19%) in the group 9 and others (primary and secondary infertility, elderly primigravida, persistent less foetal movement, induction failure) were the most common causes of CS (38.02%) in Group 10.

CONCLUSIONS

RTGC is an internationally accepted classification needed to scientifically study the effects of the rising caesarean section rate. We may reduce primary CS rate by proper antenatal check-up and labour management, external cephalic version in breech or transverse lie and conduction of assisted vaginal breech delivery in indicated cases and VBAC/ TOLAC in suitable cases of post caesarean pregnancy.

KEY WORDS

Caesarean Section, Robson’s Classification, RTGC, Retrospective

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