Uso de la clasificación de Robson en un Hospital Comarcal de España para reducir la tasa de cesáreas

Abstract

Introduction: In recent decades there has been a dramatic increase in cesarean section rate in all developed countries. The cesarean section rate in Spain, registered by the Ministry of Health was 24.9[%]. Objective: To analyze cesarean section rate in Inmaculada Local Hospital, using Robson's classification to compare it with other hospitals, both at national and international level and establish potential interventions to reduce such rate. Methods: A cesarean section rate retrospective audit was performed according to Robson's classification, from 1st January 2006 to 31st December 2013. Results: 9337 deliveries and 1507 cesareans were analyzed on that period of time. The cesarean rate was 16.14[%]. Nulliparous women with a singleton pregnancy in cephalic presentation at 37 weeks or more and undergo a labor induction before the onset of labor represent the first group of the cesareans with 25.2[%] of the total. In second place comes multiparous women with at least one previous cesarean section with a singleton pregnancy in cephalic presentation, 37 weeks or more, representing 19.4[%] of the total cesareans. This group had a 42.2[%] cesarean rate. In third place (17.4[%]) we had nulliparous women with a singleton pregnancy in cephalic presentation, 37 weeks or more, who have started labor spontaneously. Conclusions: Increased cesarean section rate in recent years required audits using a classification system, like Robson's one, to establish the groups in which it is possible to reduce the number of cesareans.