An Evaluation of Rising Cesarean Delivery Rates According to Robson Classification at a University Hospital in the Black Sea Region of Turkey: Our 13-Year Experience

English (OpenAlex)

OBJECTIVE: To analyse cesarean deliveries (CD) using the Ten Group Classification System (TGCS) for reducing cesarean rates. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Ordu University Medical Faculty Training and Research Hospital, Ordu, Turkey, from 1st January 2008 to 31st December 2020. METHODOLOGY: A total of 29,885 deliveries during the 13-year study period were analysed. Group sizes and annual, overall, absolute, and relative CD rates were calculated to analyse the effect of the Robson groups (RGs)/TGCS. The data were analysed using the two-way Chi-square test and two-proportion Z-test with Bonferroni correction. RESULTS: The overall CD rate was 59.22% (17,697). The principal contributors to the overall CD rate were RG5 (54.48%), RG1 (12.52%), and RG2 (10.06%). The relative CD rate in preterm pregnancies (RG10) increased approximately five-fold over the 13-year study period due to the increase in both group size and absolute CD rate (p<0.001). CONCLUSION: TGCS shows the cesarean delivery trends in terms of cesarean rates and identifies those groups requiring special precautions. The target groups (RG5, RG1, RG2 and RG10) need more in-depth research to reduce CD rates. Various approaches need to be implemented including individualised cesarean indication, encouragement of vaginal delivery after cesarean delivery, expectant management in nulliparous women, and spontaneous labor for preterms labor. KEY WORDS: Cesarean section, Elective cesarean section, Induction of labor, Vaginal birth after cesarean section, Robson classification, Preterm deliveries.