The Trend of Cesarean Section Rate According to Robson 10-Group Classification in Maharaj Nakhon Si Thammarat Hospital, Thailand since 2011 to 2018
Keywords:
Cesarean section rate, unnecessary cesarean section, Robson 10-group classificationAbstract
Background: Cesarean section (CS) rate in Maharaj Nakhon Si Thammarat (MNST) Hospital was continuedly increased over the past decade, disagreed with WHO consensus of optimal CS rate
Objective: To assess CS situation in Maharaj Nakhon Si Thammarat hospital according to Robson 10-group classification (R)
Materials and Methods: A retrospective cross-sectional study of the medical records of delivery women between in 2011-2018, were categorized by Robson 10-group classification (R) to interpret the situation CS rate in Maharaj Nakhon Si Thammarat hospital
Results: The total of 44,676 medical records were recruited, multiparous women with a single cephalic term in spontaneous labor (R3) was the largest group in population followed by nulliparous women with a single cephalic term in spontaneous labor (R1) and multiparous women with at least one previous uterine scar, with a single cephalic term pregnancy (R5), calculated rate were 24.5%, 20.3% and 15.6% respectively. The total CS rate was 49.5% which R5, nulliparous women with a single cephalic term who were delivered by CS before labor (R2b) and multiparous women with a single cephalic term who were delivered by CS before labor (R4b) were top three of the highest CS rate about 15.6%, 13.0% and 4.9% respectively. The CS rate of R5 was continuedly increased by the reason of R2b and R4b which were more than 10% of CS rate over 8 years. Additionally, the single cephalic pregnancy with < 37 weeks gestation (R10) also was gradually increasing that represented growing tertiary center of Maharaj Nakhon Si Thammarat hospital
Conclusions: The main cause of increasing CS rate was previous CS (R5) that result from CS before labor (R2b, R4b) in prior pregnancy. To safely reduce an unnecessary CS rate, an appropriate guideline for auditing CS indication should be developed.
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