Cesarean section rate among COVID-19 mothers and its classification through robson’s criteria

Abstract

Background: The COVID-19 epidemic that erupted in November 2019 has brought medical science to the fore in news and public perceptions. As the pandemic enters the next phase with new diversity, there are various concerns regarding pregnant women, its transmission to the unborn child, and the safe and secure method of childbirth. Both the method of vaginal delivery and the delivery phase are equally appropriate. The mode of birth a woman should go through must be personal and based entirely on the severity of the disease and obstetric indications. Methods: This was a 1-year retrospective study from April 2020 to April 2021 in the Department of Obstetrics and Gynecology of the Postgraduate Institute Yashwantrao Chavan Memorial Hospital, Pimpri, Pune. All pregnant women admitted irrespective of their gestational age or whether they were in labor or not were universally screened for COVID-19. All the delivered women were segregated based on the mode of delivery, vaginal or cesarean, and the information was then classified according to Robson’s policy. Results: The rate of cesarean section in COVID-19 patients during this 1-year period was 31.59%. Also, it was noted that the maternal mortality was more in the cases of cesarean section (1.4%) compared to vaginal delivery (0.00%). The percentage of neonates affected by COVID-19 in cesarean delivery (0.46%) was more than in vaginal delivery (0.22%). Conclusion: We conclude that there is insufficient evidence to support that the outcome of lower-segment cesarean section (LSCS) was better than vaginal delivery to prevent direct transmission from a COVID-19 pregnant mother to the neonate. The mode of delivery should be individualized and based on the severity of the disease and obstetrical indications. Therefore, in mild cases, it is advisable to continue with vaginal delivery and LSCS should be reserved for women with severe respiratory problems, where termination of pregnancy will allow for better ventilation of the newborn.