Shristy Mohanty

Ims & Sum Hospital, India

Abstract

Background

The increasing trends for caesarean section are a concern both in india and the world over. The cause for this rise is multi-factorial for example- exponential advancement in technology leading to early identification of a compromised foetus, maternal preferences, previous history of caesarean section.

Who recommends the widely accepted “robson’s ten group classification system (tgcs)”for comparing and analysing cs rates across the globe.

Method:

this is a ‘retrospective study’ aimed to analyse the rate of caesarean section in our institution which is a teaching hospital. Hospital records from 1/1/2019 to 30/6/2019 were used.

The 6 months data was entered and analysed using excel sheet and presented using “robson’s ten group classification system.”

Results:

out of 746 women who delivered during the study period of 6 months, 390 (52.27 %) delivered by cs. Group 2 (induced labour or caesarean section before labour) had the highest contribution with 35.13 %. Group 5 (previous cs) which came second, contributed 25.13 % to the total.

Conclusion:

the outcome of this study indicates that group 2 (induced labour or caesarean section before labour) and “group 5 (previous cs)” contributed the maximum to the overall rate of cs. “trial of labour after caesarean (tolac)” and “vaginal birth after caesarean (vbac)” should be routinely done with close monitoring of both foetus and the mother. There should be department protocols for induction of labour which should be followed strictly so that there is judicious use of induction. Strict implementation of “induction protocols” will lead to decrease in the number of failed inductions and eventually reduce the primary cs. It is advisable to use robson’s tgcs continually so that there is a sense of accountability. Our recommendation is to utilise this tool for watchful observation of cs rates and appropriate action to curb unnecessary, non-indicated c-sections.