Using the Robson’s Classification System to Analyze the Trend of Cesarean Section in a Tertiary Care Hospital: An Observational Study from Bangladesh

Abstract

Introduction: A caesarean section (CS) is an obstetric procedure often performed when it is determined that vaginal delivery could be harmful to either mother or the baby. There is a growing concern about the increasing percentage of CS globally and this is particularly dramatic in many middle- and high-income countries, but at a lower degree in low-income countries. Hence, this study aimed to analyze the trends in cesarean section rates at a tertiary care hospital in Bangladesh using the Robson’s classification system. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Islami Bank Hospital, Dhaka, Bangladesh from January 2023 to September 2024. Our study included 486 pregnant women who underwent a caesarean section under the Department of Obstetrics and Gynaecology of our hospital during the study period. Result: In this study, we found that group 5 (multiparous with previous CS, single cephalic, ≥37 weeks- with one previous CS and two or more CS) had the highest frequency with 220 cases (45.27%). Most of our patients (68.72%) were aged between 18-30 years and the majority (95.47%) of the deliveries occurred at gestational ages >37 weeks. Out of 229 caesarean sections, 67.08% were elective, and 32.92% were emergency cases. The most common indication for CS was PCS (45.27%), followed by poor progress in labour (21.60%) and foetal distress (13.37%). Conclusion: Our study found that the use of the Robson’s classification of CS is increasing, and Robson group 5 is the main contributor to the overall CS rate.