Ferreira Elton C, Pacagnella Rodolfo C, Costa Maria L, Cecatti Jose G
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Int J Gynaecol Obstet. 2015 Jun;129(3):236-9. doi: 10.1016/j.ijgo.2014.11.026. Epub 2015 Feb 10.
To evaluate the distribution of women according to the Robson 10-group classification system (RTGCS) and the occurrence of severe maternal morbidity (SMM) by mode of delivery at a tertiary referral hospital.
A retrospective cross-sectional study was conducted of all women admitted to the Women's Hospital at the University of Campinas (Campinas, Brazil) for delivery between January 2009 and July 2013. Women were grouped according to RTGCS. Mode of delivery and SMM (defined as need for admission to the intensive care unit) were assessed.
Among 12 771 women, 5957 (46.6%) delivered by cesarean. Overall, 3594 (28.1%) women were in group 1 (nulliparous, single pregnancy, cephalic, term, spontaneous labor), 2328 (18.2%) in group 5 (≥1 previous cesarean, single pregnancy, cephalic, term), and 2112 (16.5%) in group 3 (multiparous excluding previous cesarean, single pregnancy, cephalic, term, spontaneous labor). Group 5 contributed the most cesarean deliveries (1626 [27.3%]), followed by group 2 (nulliparous, single pregnancy, cephalic, term, induced labor or cesarean before labor; 1049 [17.6%]). SMM was more common among women undergoing cesarean delivery than among those delivering vaginally in groups 1-5.
The RTGCS allowed the identification of groups with the highest frequency of cesarean delivery and an assessment of SMM. This should be considered in related health policies.
根据罗布森10组分类系统（RTGCS）评估三级转诊医院中按分娩方式划分的女性分布情况以及严重孕产妇发病（SMM）的发生率。
对2009年1月至2013年7月间入住坎皮纳斯大学妇女医院（巴西坎皮纳斯）分娩的所有女性进行回顾性横断面研究。根据RTGCS对女性进行分组。评估分娩方式和SMM（定义为需要入住重症监护病房）。
在12771名女性中，5957名（46.6%）通过剖宫产分娩。总体而言，3594名（28.1%）女性属于第1组（初产妇，单胎妊娠，头位，足月，自然分娩），2328名（18.2%）属于第5组（既往有≥1次剖宫产史，单胎妊娠，头位，足月），2112名（16.5%）属于第3组（经产妇，不包括既往剖宫产史，单胎妊娠，头位，足月，自然分娩）。第5组剖宫产分娩最多（1626例[27.3%]），其次是第2组（初产妇，单胎妊娠，头位，足月，引产或临产前剖宫产；1049例[17.6%]）。在第1 - 5组中，SMM在剖宫产分娩的女性中比经阴道分娩的女性更常见。
RTGCS有助于识别剖宫产分娩频率最高的组并评估SMM。在相关卫生政策中应予以考虑。
