European Journal of Cardiovascular Medicine

Background: The escalating rates of cesarean sections (CS) globally necessitate evidence-based strategies to mitigate unnecessary surgeries. Robson's ten-group classification system offers a standardized approach to assess CS rates across diverse healthcare settings. Understanding the factors contributing to CS rates is crucial for effective obstetric management. Methods: This study analyzed 346 cases of CS using Robson's classification scheme, incorporating data on demographics, gestational age, parity, onset of labor, and indications for CS. The sample size was determined based on previous research, and data were collected from case records using a proforma. The primary objective was to identify the group exerting the most significant influence on CS rates and evaluate rates within each category. Results: Group 5, comprising women with a history of previous CS, contributed notably to overall CS rates. Fetal distress emerged as a predominant indication for primary CS, followed by malpresentation of the fetus and failed induction. Groups 1 and 3, involving spontaneous labor, exhibited moderate contributions to CS rates. Conversely, Groups 6, 7, and 10 represented smaller proportions, indicating lesser impact on CS rates. Conclusion: The study underscores the significance of Robson's classification in assessing CS rates and identifying key contributors. Women with prior CS represent a substantial proportion of CS cases, highlighting the importance of offering trial of labor after cesarean section (TOLAC) where feasible. Efforts to enhance obstetric care should include improved training in fetal monitoring interpretation and reinstating skills in assisted vaginal breech birth and external cephalic version. By addressing these factors, healthcare facilities can strive towards optimizing CS rates while ensuring safe maternal and neonatal outcomes.