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Abstract
Background:
The rate of caesarean section (CS) has increased globally, raising concerns regarding its appropriate use and associated maternal and neonatal outcomes. The Robson Classification System provides a standardized method for evaluating and comparing CS rates across different populations.
Objective:
To determine the frequency of indications for caesarean section according to the Robson Classification System in a tertiary care hospital.
Methods:
This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Civil Hospital Karachi over a period of 6 months. All women undergoing caesarean section during the study period were included. Patients were classified into ten groups according to the Robson Classification System based on obstetric characteristics. Data regarding demographic profile, obstetric variables, and indications for caesarean section were collected. Data were analyzed using SPSS 26, and results were expressed as frequencies and percentages.
Results:
Out of 2,860 total deliveries, 1,032 (36.1%) were delivered by caesarean section. The highest contribution to the overall CS rate was from Robson Group 5 (34.2%), followed by Group 1 (18.4%) and Group 2 (16.7%). The most common indications for caesarean section were previous caesarean section (34.2%), fetal distress (21.6%), and failure to progress (15.8%). Other indications included hypertensive disorders (9.7%), malpresentation (7.5%), and cephalopelvic disproportion (5.3%).
Conclusion:
The Robson Classification System is an effective tool for auditing caesarean section rates. Previous caesarean section is the leading contributor, emphasizing the need to reduce primary CS rates and promote safe vaginal birth after caesarean (VBAC).