Analysis of Cesarean Section According to Robson Ten Group Classification in Chittagong Medical College Hospital

Open Access

Abstract

Background: The global rate of cesarean section (CS) has increased markedly over recent decades, raising concerns about unnecessary procedures and associated maternal and neonatal complications. The Robson Ten Group Classification System provides a standardized and widely accepted method to evaluate, compare, and monitor CS rates across healthcare facilities. Aim of the study: To analyze cesarean section cases according to the Robson Ten Group Classification System at Chittagong Medical College Hospital, Bangladesh, and identify the major contributing obstetric groups to the overall CS rate. Methods & Materials: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynecology at Chittagong Medical College Hospital from November 2019 to April 2020. A total of 253 women who underwent cesarean delivery were included using convenient sampling. Participants were categorized according to the Robson Ten Group Classification System based on parity, gestational age, fetal presentation, number of fetuses, and onset of labor. Data were collected using structured forms from patient interviews, clinical examinations, and hospital records. Statistical analysis was performed using SPSS version 25.0. Categorical variables were expressed as frequency and percentage, while continuous variables were presented as mean ± standard deviation or median with interquartile range Result: The majority of patients were aged 21–25 years (34.39%), followed by 26–30 years (30.04%). Most participants were multiparous (57.71%), and 82.21% had term pregnancies. Cephalic presentation was observed in 86.96% of cases. Regular antenatal care was reported by only 18.58% of women. According to the Robson Ten Group Classification System, Group 5 (multiparous women with previous CS, singleton, cephalic, ≥37 weeks) contributed the largest proportion of cesarean deliveries (26.48%), followed by Group 2 (18.58%) and Group 1 (16.60%). Smaller contributions were observed from Groups 3 and 4 (9.49% each), while Groups 6–10 accounted for comparatively lower proportions. Conclusion: The study demonstrated that previous cesarean section (Robson Group 5) was the major contributor to the overall CS rate. Application of the Robson Ten Group Classification System provides a practical and standardized approach for monitoring cesarean deliveries and identifying target groups for reducing unnecessary CS. Strengthening antenatal care and promoting appropriate labor management strategies may help optimize cesarean section rates and improve maternal health outcomes.