Analysis of Cesarean Section Rates at a Tertiary Care Hospital in Uttarakhand Using the Robson Ten-group Classification System

Background:The global rise in cesarean section (CS) rates is worrisome because of the possible maternal risks for the current and subsequent pregnancies associated with CS.The Robson ten-group classification system (RTGCS) allows for institution-specific auditing and analysis of CSs.The objectives of the present study were to find out the overall CS rate and use the RTGCS to determine the groups that contributed most to the overall CS rate, as well as to ascertain the CS rates within these groups at a tertiary health care facility in Uttarakhand, India. Materials and methods:The medical records of all women who had vaginal delivery or CS (after fetal viability) at our facility between 1st January 2024 and 31st December 2024 were reviewed retrospectively to gather pertinent obstetric data.The participants were grouped as per RTGCS.For each group, its size, its CS rate, and its absolute and relative contributions to the overall CS rate were calculated.Results: The overall CS rate was 46.5%.Group I was the largest group, followed by group III and group X, with group sizes of 25.9, 21.9, and 19.1%, respectively.Group V was the largest contributor to the overall CS rate, followed by groups I and X, with relative contributions of 27.7, 23.3, and 19.7%, respectively.Conclusion: Group V and group I contributed the most to the overall CS rate.Reducing the primary CS rate and offering a trial of labor to women with previous CS can minimize the CS rate in group V. Clinical significance: The RTGCS offers a standardized approach to auditing CS rates, identifying high-contributing groups, and guiding targeted strategies to reduce unnecessary CSs without compromising maternal or neonatal outcomes.