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Comparative Study
. 2018 Sep;40(9):513-517.
doi: 10.1055/s-0038-1667340. Epub 2018 Aug 2.

Robson Classification System Applied to Induction of Labor

Sara Vargas  1 , Susana Rego  1 , Nuno Clode  1
Affiliations
Comparative Study

Robson Classification System Applied to Induction of Labor

Sara Vargas et al. Rev Bras Ginecol Obstet. 2018 Sep.

Abstract
in English, Portuguese

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 preferred method 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.

INTRODUçãO: A indução do trabalho de parto é uma prática comum e sua associação com o aumento da taxa de cesarianas tem sido questionada. O presente estudo surge com o objetivo de avaliar o impacto da indução do trabalho de parto na taxa global de cesarianas e de analisar as taxas de cesarianas de acordo com o método de indução do trabalho de parto utilizado e com o grupo de Robson. MéTODOS: Realizamos um estudo retrospectivo com inclusão de grávidas submetidas a indução do trabalho de parto em um hospital terciário em 2015 e 2016. Todas as mulheres forram classificadas de acordo com a classificação de Robson. As taxas de cesarianas foram analisadas e comparadas em função do método de indução de trabalho de parto utilizado.

Resultados: Foram incluídos 1.166 casos. A taxa de cesarianas após a indução do trabalho de parto foi de 20,9%, correspondendo a 23,1% do total de cesarianas realizadas em 2015 e 2016. Os grupos 5 e 8 da classificação de Robson foram os que apresentaram as maiores taxas de cesarianas (65,2% e 32,3%, respectivamente). O grupo 2 foi o que mais contribuiu para a taxa global de cesarianas, por representar 56,7% do total da população. As prostaglandinas intravaginais foram o método mais utilizado (77%). O cateter de Foley transcervical foi o método mais utilizado no grupo 5 e as prostaglandinas intravaginais nos restantes. A taxa de cesarianas foi superior quando se utilizou o cateter de Foley transcervical (34,1%). CONCLUSãO: A indução do trabalho de parto com cateter de Foley transcervical associou-se a uma maior taxa de cesarianas, em provável relação com a sua maior utilização no grupo 5.

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Conflict of interest statement

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