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. 2010 Jun 26:7:13.
doi: 10.1186/1742-4755-7-13.

Using a Caesarean Section Classification System based on characteristics of the population as a way of monitoring obstetric practice

Maria L Costa  1 , Jose G Cecatti, João P Souza, Helaine M Milanez, Metin A Gülmezoglu
Affiliations

Using a Caesarean Section Classification System based on characteristics of the population as a way of monitoring obstetric practice

Maria L Costa et al. Reprod Health. .

Abstract

Objective: to compare the distribution of caesarean rates in the Robson's 10 groups classification in order to see if any change occurred after the implementation of an audit and feedback intervention.

Design: cross sectional, before and after an audit and feedback study.

Setting: a university hospital in Brazil.

Methods: clinical records of all births during two three months-periods were evaluated. Each case of CS was classified into one of ten mutually exclusive categories according to obstetric characteristics. The proportion of CS in each group was compared in both periods.

Results: total number of deliveries and the high rate of CS were similar in both periods. Group 3 (multiparous excluding previous CS, single, cephalic, >/= 37 weeks, spontaneous labour) accounted for the largest proportion of deliveries, 28.5 and 26.8% in both periods. Group 1 (nulliparous, single, cephalic, >/= 37 weeks, spontaneous labour) was the second largest one, while Group 5 (previous caesarean section, single, cephalic, and >/= 37 weeks) was the third but the largest contributor to CS, accounting for 16.6 and 14.9% among all deliveries in both periods. Groups 2 (nulliparous, single, cephalic, >/= 37 weeks, induction or CS before labour) and 4 (multiparous excluding previous CS, single, cephalic, >/= 37 weeks, induction or CS before labour) were less prevalent, however had higher rates of CS. Only in Group 10 (All single, cephalic, </= 36 weeks, including previous CS), there was a significant decrease of CS rate from 70.5 to 42.6% between periods.

Conclusion: Robson's classification did not identify any significant change in the pattern of CS rates with the audit and feedback process, but showed to be useful for comparing trends among similar obstetric populations.

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References

    1. Robson MS. Classification of Cesarean Sections. Fetal and Maternal Medicine Review. 2001;12(1):23–39. doi: 10.1017/S0965539501000122. - DOI
    1. World Health Organization. Appropriate technology for birth. Lancet. 1985;326(8452):436–7. doi: 10.1016/S0140-6736(85)92750-3. - DOI - PubMed
    1. Barros FC, Vaughan JP, Victora CG, Huttly SRA. Epidemic of Caesarean sections in Brazil. Lancet. 1991;338:167–9. doi: 10.1016/0140-6736(91)90149-J. - DOI - PubMed
    1. Faundes A, Cecatti JG. Which policy for Caesarean section in Brazil? An analysis of trends and consequences. Health Policy Plann. 1991;8:33–42.
    1. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodonico L, Bataglia V, Faundes A, Langer A, Narvaez A, Donner A, Romero M, Reynoso S, de Padua KS, Giordano D, Kublickas M, Acosta A. for the WHO 2005 global survey on maternal and perinatal health research group. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006;367(9535):1819–29. doi: 10.1016/S0140-6736(06)68704-7. - DOI - PubMed

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