Mittal Pratima, Pandey Divya, Suri Jyotsna, Bharti Rekha
Department of Obstetrics and Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India.
J Obstet Gynaecol India. 2020 Apr;70(2):111-118. doi: 10.1007/s13224-019-01275-7. Epub 2019 Oct 11.
World Health Organization proposed use of Robson Classification as a global standard for assessing, maintaining and comparing Cesarean section (CS) rates. This paper aimed to examine CS trend at a tertiary center according to Robson Ten-Group Classification System (TGCS) over three-year period (2015-2017) and to predict future Cesarean trends.
This prospective observational study was conducted at a tertiary teaching institute and included 81,784 females who delivered at this hospital over three-year duration (2015-2017). The data compilation was done according to Robson TGCS. The main outcome measures were overall annual CS rates, Robson group-wise CS rates, future overall and Robson group-wise CS trend. These parameters were calculated, trend analysis was done and trend over future 3 years was predicted.
There were 81,784 deliveries (62,336 vaginal and 19,448 Cesarean deliveries) over the study period. The year-wise CS rate was 22.4%, 23.5% and 25.5%, respectively. The largest contribution was by group 5 followed by group 2 and group 1. Based on 3-year data, it was predicted that CS rate will increase by 0.905% annually over coming 3 years. In groups 3, 4, 6, 7 and 8, predicted trend value showed an annual increase by 0.65%, 0.05%, 0.05%, 0.05% and 0.10%, respectively; in groups 1, 2, 5, 9 and 10, it showed an annual decrease of 0.45%, 0.05%, 1.50%, 0.50% and 0.05%, respectively.
Increasing CS rate trend was seen over last 3 years with a predicted rise of 0.905% per year. Robson groups 5, 2 and 1 were at present major contributors; however, the trend analysis predicted a decreasing trend. Trend analysis predicted annual increment in groups 3, 4, 6, 7 and 8 over next 3 years, thereby suggesting need to focus on these groups as well.
世界卫生组织提议将罗布森分类法作为评估、维持和比较剖宫产（CS）率的全球标准。本文旨在根据罗布森十组分类系统（TGCS）研究某三级医疗中心三年期间（2015 - 2017年）的剖宫产趋势，并预测未来的剖宫产趋势。
这项前瞻性观察性研究在一家三级教学机构进行，纳入了在该医院三年期间（2015 - 2017年）分娩的81784名女性。数据收集按照罗布森TGCS进行。主要观察指标为总体年度剖宫产率、按罗布森分组的剖宫产率、未来总体及按罗布森分组的剖宫产趋势。计算这些参数，进行趋势分析并预测未来3年的趋势。
研究期间共有81784例分娩（62336例阴道分娩和19448例剖宫产）。逐年的剖宫产率分别为22.4%、23.5%和25.5%。贡献最大的是第5组，其次是第2组和第1组。根据三年数据预测，未来三年剖宫产率将每年增加0.905%。在第3、4、6、7和8组中，预测趋势值显示每年分别增加0.65%、0.05%、0.05%、0.05%和0.10%；在第1、2、5、9和10组中，显示每年分别下降0.45%、0.05%、1.50%、0.50%和0.05%。
过去三年剖宫产率呈上升趋势，预计每年上升0.905%。目前罗布森第5、2和1组是主要贡献者；然而，趋势分析预测呈下降趋势。趋势分析预测未来三年第3、4、6、7和8组将逐年增加，因此也表明需要关注这些组。
