-
Original Article
Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
- Jaqueline Brandão Mazzola
, - Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal , [ ... ],
- Luciano Marcondes Machado Nardozza
07-26-2024
Summary
Original ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
07-26-2024- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views150Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee moreViews150
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
07-26-2024- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views150Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Jaqueline Brandão Mazzola
-
Original Article
Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares , [ ... ],
- Sue Yazaki Sun
06-27-2024
Summary
Original ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
06-27-2024- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views158Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee moreViews158This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
06-27-2024- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views158Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Amanda Botelho
-
Original Article
Increased Cesarean Section Rates during the COVID-19 Pandemic: Looking for Reasons through the Robson Ten Group Classification System
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(7):371-376
09-08-2023
Summary
Original ArticleIncreased Cesarean Section Rates during the COVID-19 Pandemic: Looking for Reasons through the Robson Ten Group Classification System
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(7):371-376
09-08-2023Views114See moreAbstract
Objective
To compare cesarean section (CS) rates according to the Robson Ten Group Classification System (RTGCS) and its indications in pregnant women admitted for childbirth during the first wave of the coronavirus disease 2019 (COVID-19) pandemic with those of the previous year.
Materials and Methods
We conducted a cross-sectional study to compare women admitted for childbirth from April to October 2019 (before the pandemic) and from March to September 2020 (during the pandemic). The CSs and their indications were classified on admission according to the RTGCS, and we also collected data on the route of delivery (vaginal or CS). Both periods were compared using the Chi-squared (χ2) test or the Fisher exact test.
Results
In total, 2,493 women were included, 1,291 in the prepandemic and 1,202 in the pandemic period. There was a a significant increase in the CS rate (from 39.66% to 44.01%; p = 0.028), mostly due to maternal request (from 9.58% to 25.38%; p < 0.01). Overall, groups 5 and 2 contributed the most to the CS rates. The rates decreased among group 1 and increased among group 2 during the pandemic, with no changes in group 10.
Conclusion
There was an apparent change in the RTGSC comparing both periods, with a significant increase in CS rates, mainly by maternal request, most likely because of changes during the pandemic and uncertainties and fear concerning COVID-19.
Views114This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleIncreased Cesarean Section Rates during the COVID-19 Pandemic: Looking for Reasons through the Robson Ten Group Classification System
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(7):371-376
09-08-2023Views114See moreAbstract
Objective
To compare cesarean section (CS) rates according to the Robson Ten Group Classification System (RTGCS) and its indications in pregnant women admitted for childbirth during the first wave of the coronavirus disease 2019 (COVID-19) pandemic with those of the previous year.
Materials and Methods
We conducted a cross-sectional study to compare women admitted for childbirth from April to October 2019 (before the pandemic) and from March to September 2020 (during the pandemic). The CSs and their indications were classified on admission according to the RTGCS, and we also collected data on the route of delivery (vaginal or CS). Both periods were compared using the Chi-squared (χ2) test or the Fisher exact test.
Results
In total, 2,493 women were included, 1,291 in the prepandemic and 1,202 in the pandemic period. There was a a significant increase in the CS rate (from 39.66% to 44.01%; p = 0.028), mostly due to maternal request (from 9.58% to 25.38%; p < 0.01). Overall, groups 5 and 2 contributed the most to the CS rates. The rates decreased among group 1 and increased among group 2 during the pandemic, with no changes in group 10.
Conclusion
There was an apparent change in the RTGSC comparing both periods, with a significant increase in CS rates, mainly by maternal request, most likely because of changes during the pandemic and uncertainties and fear concerning COVID-19.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article
Gestational Risk as a Determining Factor for Cesarean Section according to the Robson Classification Groups
- Karina Biaggio Soares ,
- Vanessa Cristina Grolli Klein ,
- José Antônio Reis Ferreira de Lima ,
- Lucas Gadenz ,
- Larissa Emile Paulo , [ ... ],
- Cristine Kolling Konopka
01-19-2021
Summary
Original ArticleGestational Risk as a Determining Factor for Cesarean Section according to the Robson Classification Groups
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):84-90
01-19-2021- Karina Biaggio Soares ,
- Vanessa Cristina Grolli Klein ,
- José Antônio Reis Ferreira de Lima ,
- Lucas Gadenz ,
- Larissa Emile Paulo ,
- Cristine Kolling Konopka
Views199See moreAbstract
Objective
To analyze and compare the frequency of cesarean sections and vaginal deliveries through the Robson Classification in pregnant women attended at a tertiary hospital in two different periods.
Methods
Cross-sectional, retrospective study of birth records, comprising 4,010 women, conducted from January 2014 to December 2015 in the only public regional referral hospital for the care of high- risk pregnancies, located in Southern Brazil.
Results
The overall cesarean section rate reached 57.5% and the main indication was the existence of a previous uterine cesarean scar. Based on the Robson Classification, groups 5 (26.3%) and 10 (17.4%) were the most frequent ones. In 2015, there was a significant increase in the frequency of groups 1 and 3 (p < 0.001), when compared with the previous year, resulting in an increase in the number of vaginal deliveries (p < 0.0001) and a reduction in cesarean section rates.
Conclusion
The Robson Classification proved to be a useful tool to identify the profile of parturients and the groups with the highest risk of cesarean sections in different periods in the same service. Thus, it allowsmonitoring in a dynamic way the indications and delivery routes and developing actions to reduce cesarean rates according to the characteristics of the pregnant women attended.
Views199This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleGestational Risk as a Determining Factor for Cesarean Section according to the Robson Classification Groups
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):84-90
01-19-2021- Karina Biaggio Soares ,
- Vanessa Cristina Grolli Klein ,
- José Antônio Reis Ferreira de Lima ,
- Lucas Gadenz ,
- Larissa Emile Paulo ,
- Cristine Kolling Konopka
Views199See moreAbstract
Objective
To analyze and compare the frequency of cesarean sections and vaginal deliveries through the Robson Classification in pregnant women attended at a tertiary hospital in two different periods.
Methods
Cross-sectional, retrospective study of birth records, comprising 4,010 women, conducted from January 2014 to December 2015 in the only public regional referral hospital for the care of high- risk pregnancies, located in Southern Brazil.
Results
The overall cesarean section rate reached 57.5% and the main indication was the existence of a previous uterine cesarean scar. Based on the Robson Classification, groups 5 (26.3%) and 10 (17.4%) were the most frequent ones. In 2015, there was a significant increase in the frequency of groups 1 and 3 (p < 0.001), when compared with the previous year, resulting in an increase in the number of vaginal deliveries (p < 0.0001) and a reduction in cesarean section rates.
Conclusion
The Robson Classification proved to be a useful tool to identify the profile of parturients and the groups with the highest risk of cesarean sections in different periods in the same service. Thus, it allowsmonitoring in a dynamic way the indications and delivery routes and developing actions to reduce cesarean rates according to the characteristics of the pregnant women attended.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Karina Biaggio Soares
-
Original Article
Improving the Management of High-Risk Pregnancies with the Use of the Robson Classification
- Mario Dias Correa Junior ,
- Bárbara Moreira Ribeiro Trindade dos Santos ,
- José Reinaldo Correa Roveda ,
- Laura Carolina Menezes Vieira Silva ,
- Larissa Silva Guimarães , [ ... ],
- Samuel Cristóvão Lopes Gonçalves
09-25-2020
Summary
Original ArticleImproving the Management of High-Risk Pregnancies with the Use of the Robson Classification
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):448-453
09-25-2020- Mario Dias Correa Junior ,
- Bárbara Moreira Ribeiro Trindade dos Santos ,
- José Reinaldo Correa Roveda ,
- Laura Carolina Menezes Vieira Silva ,
- Larissa Silva Guimarães ,
- Samuel Cristóvão Lopes Gonçalves
Views168Abstract
Objective
To analyze the rates of cesarean delivery longitudinally in a university hospital using the Robson classification.
Methods
Data related to births performed between 2014 and 2018 and recorded in the Maternal and Neonatal Health Information System (Sistema de Informações em Saúde Materna e Neonatal, SISMATER, in Portuguese) were analyzed using the Robson classification. As an aid, we used articles published in the last five years that approach the same topic in other Brazilian maternity hospitals; they were retrieved from the LILACS, MEDLINE, CINAHL, Scopus, Web of Science and Cochrane Library databases.
Results
There was little variation in the total rate of cesarean sections in the period; however, the profile of each group changed over the years. It was possible to verify a significant reduction in the participation of groups of pregnant women with lower risk and an increase in high-risk pregnancies, attributable to the decrease in beds in the institution, with a greater transfer of patients. In addition, there was a reduction in cesarean sections among the lower-risk groups,while the rate among the higher-risk groups remained stable.
Conclusion
The use of the Robson classification to stratify cesarean deliveries contributes to a better analysis of the indications for cesarean delivery, enabling the establishment of strategies to reduce the rates, generating a positive impact on hospital management and quality of care.
Key-words birthing centersCesarean sectionevidence-based clinical practicehospitalmanagementmaternityrobson classificationSee moreViews168This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleImproving the Management of High-Risk Pregnancies with the Use of the Robson Classification
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):448-453
09-25-2020- Mario Dias Correa Junior ,
- Bárbara Moreira Ribeiro Trindade dos Santos ,
- José Reinaldo Correa Roveda ,
- Laura Carolina Menezes Vieira Silva ,
- Larissa Silva Guimarães ,
- Samuel Cristóvão Lopes Gonçalves
Views168Abstract
Objective
To analyze the rates of cesarean delivery longitudinally in a university hospital using the Robson classification.
Methods
Data related to births performed between 2014 and 2018 and recorded in the Maternal and Neonatal Health Information System (Sistema de Informações em Saúde Materna e Neonatal, SISMATER, in Portuguese) were analyzed using the Robson classification. As an aid, we used articles published in the last five years that approach the same topic in other Brazilian maternity hospitals; they were retrieved from the LILACS, MEDLINE, CINAHL, Scopus, Web of Science and Cochrane Library databases.
Results
There was little variation in the total rate of cesarean sections in the period; however, the profile of each group changed over the years. It was possible to verify a significant reduction in the participation of groups of pregnant women with lower risk and an increase in high-risk pregnancies, attributable to the decrease in beds in the institution, with a greater transfer of patients. In addition, there was a reduction in cesarean sections among the lower-risk groups,while the rate among the higher-risk groups remained stable.
Conclusion
The use of the Robson classification to stratify cesarean deliveries contributes to a better analysis of the indications for cesarean delivery, enabling the establishment of strategies to reduce the rates, generating a positive impact on hospital management and quality of care.
Key-words birthing centersCesarean sectionevidence-based clinical practicehospitalmanagementmaternityrobson classificationSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Mario Dias Correa Junior
-
Original Article
Pattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification – 2015/2016
- Luciana Leite de Mattos Alcantara ,
- Núbia Karla de Oliveira Almeida ,
- Renan Moritz Varnier Rodrigues de Almeida
08-26-2020
Summary
Original ArticlePattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification – 2015/2016
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):373-379
08-26-2020- Luciana Leite de Mattos Alcantara ,
- Núbia Karla de Oliveira Almeida ,
- Renan Moritz Varnier Rodrigues de Almeida
Views107See moreAbstract
Objective
To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck.
Methods
Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables.
Results
Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a sameRobson group, the chance of C-section increases when maternal age rises (OR = 3.33 for 41-45 years old), there is the presence of a partner (OR = 1.81) and prenatal care improves (OR = 3.19 for “adequate plus”).
Conclusion
There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.
Views107This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticlePattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification – 2015/2016
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):373-379
08-26-2020- Luciana Leite de Mattos Alcantara ,
- Núbia Karla de Oliveira Almeida ,
- Renan Moritz Varnier Rodrigues de Almeida
Views107See moreAbstract
Objective
To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck.
Methods
Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables.
Results
Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a sameRobson group, the chance of C-section increases when maternal age rises (OR = 3.33 for 41-45 years old), there is the presence of a partner (OR = 1.81) and prenatal care improves (OR = 3.19 for “adequate plus”).
Conclusion
There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Luciana Leite de Mattos Alcantara
-
Original Article
Exploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates
- Mahera Abdulrahman ,
- Sara Saad Abdullah,
- Aminah Fuad Khalil Alaani,
- Noora Hassan AlAbdool,
- Fatma Elzahraa Yehia Sherif, [ ... ],
- Frederick R Carrick
03-14-2019
Summary
Original ArticleExploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):147-154
03-14-2019- Mahera Abdulrahman ,
- Sara Saad Abdullah,
- Aminah Fuad Khalil Alaani,
- Noora Hassan AlAbdool,
- Fatma Elzahraa Yehia Sherif,
- Zainab SalahEldin Ahmed,
- Hiba Issa Al-Rawi,
- Nawal Mahmood Hubaishi,
- Muna AbdulRazzaq Tahlak,
- Frederick R Carrick
Views114Abstract
Objective
The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system.
Methods
Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE).
Results
The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson’s classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. The results indicate that labor was spontaneous in 2,221 (45%) of the women and was augmented or induced in almost 1,634 cases (33%). The birth indication rate was of 64% for normal vaginal delivery, of 24% for emergency CS, and of 9% for elective CS.The rate of vaginal birth after cesarean was 261(6%), the rate of external cephalic version was 28 (0.7%), and the rate of induction was 1,168 (21.4%). The prevalence of the overall Cesarean section was 33%; with majority (53.5%) of it being repeated Cesarean section.
Conclusion
The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.
Key-words cesarean section rateobstetrical interventionsrobson classificationunited arab emiratesWomenSee moreViews114This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleExploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):147-154
03-14-2019- Mahera Abdulrahman ,
- Sara Saad Abdullah,
- Aminah Fuad Khalil Alaani,
- Noora Hassan AlAbdool,
- Fatma Elzahraa Yehia Sherif,
- Zainab SalahEldin Ahmed,
- Hiba Issa Al-Rawi,
- Nawal Mahmood Hubaishi,
- Muna AbdulRazzaq Tahlak,
- Frederick R Carrick
Views114Abstract
Objective
The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system.
Methods
Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE).
Results
The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson’s classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. The results indicate that labor was spontaneous in 2,221 (45%) of the women and was augmented or induced in almost 1,634 cases (33%). The birth indication rate was of 64% for normal vaginal delivery, of 24% for emergency CS, and of 9% for elective CS.The rate of vaginal birth after cesarean was 261(6%), the rate of external cephalic version was 28 (0.7%), and the rate of induction was 1,168 (21.4%). The prevalence of the overall Cesarean section was 33%; with majority (53.5%) of it being repeated Cesarean section.
Conclusion
The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.
Key-words cesarean section rateobstetrical interventionsrobson classificationunited arab emiratesWomenSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Mahera Abdulrahman
-
Original Articles
Robson Classification System Applied to Induction of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):513-517
09-01-2018
Summary
Original ArticlesRobson Classification System Applied to Induction of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):513-517
09-01-2018Views75See moreAbstract
Objective
Induction of labor (IL) is a common obstetric procedure, but it is questionable whether or not it results in higher cesarean section (CS) rates. The present study aims to evaluate the impact of IL in the overall CS rates and to analyze these rates according to the method of IL employed and to the Robson group in which it was applied.
Methods
We have conducted a retrospective study including pregnant women whose labor was induced at a tertiary hospital in 2015 and 2016. All women were classified according to the Robson Classification System (RCS). The CS rates were analyzed and compared regarding the method of IL employed.
Results
A total of 1,166 cases were included. The CS rate after IL was 20.9%, which represented 23.1% of the total of CSs performed in 2015 and 2016. The highest CS rates were recorded in RCS groups 5 (65.2%) and 8 (32.3%). Group 2 was the highest contributor to the overall CS rate, since it represented 56.7% of the population. The intravaginal prostaglandins method was the most used (77%). Transcervical Foley catheter was the preferredmethod in group 5 and intravaginal prostaglandins in all the other groups. The CS rate was higher when transcervical Foley catheter was used (34.1%).
Conclusion
Transcervical Foley catheter induction was associated with a higher rate of CS, probably because it was the preferred method used in group 5.
Views75This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticlesRobson Classification System Applied to Induction of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):513-517
09-01-2018Views75See moreAbstract
Objective
Induction of labor (IL) is a common obstetric procedure, but it is questionable whether or not it results in higher cesarean section (CS) rates. The present study aims to evaluate the impact of IL in the overall CS rates and to analyze these rates according to the method of IL employed and to the Robson group in which it was applied.
Methods
We have conducted a retrospective study including pregnant women whose labor was induced at a tertiary hospital in 2015 and 2016. All women were classified according to the Robson Classification System (RCS). The CS rates were analyzed and compared regarding the method of IL employed.
Results
A total of 1,166 cases were included. The CS rate after IL was 20.9%, which represented 23.1% of the total of CSs performed in 2015 and 2016. The highest CS rates were recorded in RCS groups 5 (65.2%) and 8 (32.3%). Group 2 was the highest contributor to the overall CS rate, since it represented 56.7% of the population. The intravaginal prostaglandins method was the most used (77%). Transcervical Foley catheter was the preferredmethod in group 5 and intravaginal prostaglandins in all the other groups. The CS rate was higher when transcervical Foley catheter was used (34.1%).
Conclusion
Transcervical Foley catheter induction was associated with a higher rate of CS, probably because it was the preferred method used in group 5.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
robson classification Archives - Revista Brasileira de Ginecologia e Obstetrícia
