Background: Caesarean section (CS) is a lifesaving operation that may reduce mother & infant morbidity and mortality.
Aim of the work: This research aimed to apply the Robson classification to determine trends in CS rates & the groups of women who were primarily responsible for the rising rates.
Patients and methods: This study was carried out at the Al-Azhar University Hospital (Damietta, Egypt). Information was gathered from the medical records of every woman who gave birth among February 2023 & February 2024. After calculating the overall rate of ACS, women were divided into 10 Robson groups. Calculations were made to determine each group's relative size, the contribution to the overall CS rate & CS rate within each group.
Results: The largest contributor to the overall CS rate was multiparous women with at least one previous CS, single cephalic pregnancy, ≥37 weeks' gestation, accounting for 43.6% of all deliveries and 56.7% of all CS. The relatively high CS rate in nulliparous women with single cephalic pregnancy, ≥37 weeks' gestation, spontaneous labor at 34.1% is also noteworthy. Group 2 showed a higher CS rate at 82.6%. Group 10 (all single cephalic, <37weeks gestation, containing previous CS) was the second-largest contributor, representing 20.3% of all deliveries with a high CS rate of 88.2%. Group 3 (multiparous women without a previous CS, single cephalic pregnancy, ≥37weeks gestation, spontaneous labor) showed the highest rate of NVD (96.5%). The 100.0% CS rate in Groups 7 (multiparous breech) & 9 (all abnormal lies) is not unexpected given the higher risks associated with these presentations.
Conclusion: This study highlights a high CS rate, with previous CS and pre-labor CS. Using the Robson classification, we identified previous CS and pre-term cephalic deliveries as major contributors to the CS rate, while multiparous women without previous CS had the highest rate of normal vaginal delivery.