Kabore Charles, Tiendrebeogo Simon, Betran Ana Pilar, Ravit Marion, Robson Michael, Dumont Alexandre
Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso.
BMJ Open. 2025 Mar 13;15(3):e086892. doi: 10.1136/bmjopen-2024-086892.
Objective: This study aimed to use the Robson Ten Group Classification System (TGCS) to assess caesarean section (CS) rates and other outcomes in eight referral hospitals in Burkina Faso before the implementation of non-clinical interventions to reduce unnecessary CSs.
This is a cross-sectional study.
We conducted a 9-month prospective observational study on women who gave birth at eight referral hospitals in Burkina Faso between 1 April 2020 and 31 December 2020.
We analysed 24 643 women who gave birth at the eight participating hospitals during the study period.
We reported the relative size, CS rate and absolute contribution of each Robson group. These indicators were calculated for both referred and non-referred women. Oxytocin administration and stillbirth rates were calculated for women without previous CS and with a single fetus at cephalic presentation at term (groups 1-4).
Overall, 24 643 women gave birth at the eight participating hospitals during the 9- month study period. The overall CS rate was 30.6%. Women in spontaneous labour with a single fetus in the cephalic presentation at term without previous CS (groups 1 and 3) had high CS rates (26.5% and 15%, respectively), low oxytocin use (7.9% and 6.5%, respectively), and high stillbirth rates (3.4% and 3.9%, respectively). These subgroups of women were major contributors to the overall CS rate.
Our results indicate that, in referral hospitals in Burkina Faso, the CS practice for referred women in groups 1 and 3 of the TGCS should receive special attention. These results also reveal areas for clinical improvement to reduce primary CS, especially in nulliparous women. The use of the TGCS is important in low-income countries where low CS rates at the population level may conceal suboptimal labour management in healthcare facilities.
ISRCTN67214403.
目的：本研究旨在使用罗布森十组分类系统（TGCS）评估布基纳法索八家转诊医院在实施非临床干预措施以减少不必要剖宫产（CS）之前的剖宫产率及其他结局。
这是一项横断面研究。
我们于2020年4月1日至2020年12月31日期间，对在布基纳法索八家转诊医院分娩的妇女进行了为期9个月的前瞻性观察研究。
我们分析了研究期间在八家参与医院分娩的24643名妇女。
我们报告了每个罗布森组的相对规模、剖宫产率及绝对贡献。这些指标针对转诊和未转诊妇女分别进行计算。对未行过剖宫产且单胎足月头先露的妇女（第1 - 4组）计算催产素使用情况和死产率。
总体而言，在为期9个月的研究期间，有24643名妇女在八家参与医院分娩。总体剖宫产率为30.6%。足月单胎头先露且未行过剖宫产的自然分娩妇女（第1组和第3组）剖宫产率较高（分别为26.5%和15%），催产素使用率较低（分别为7.9%和6.5%），死产率较高（分别为3.4%和3.9%）。这些妇女亚组是总体剖宫产率的主要贡献者。
我们的结果表明，在布基纳法索的转诊医院，TGCS第1组和第3组转诊妇女的剖宫产实践应受到特别关注。这些结果还揭示了临床改进的领域，以减少初次剖宫产，尤其是在未生育妇女中。在低收入国家，总体剖宫产率较低可能掩盖了医疗机构中不理想的分娩管理情况，此时使用TGCS很重要。
ISRCTN67214403。
