Pham Hai Thanh, Le Thanh Quang, Tran Nam Hoang
Directorate, Tu Du Hospital, 284 Cong Quynh, Ho Chi Minh City 700000, Vietnam.
Research Center for Higher Education, Tokushima University, Tokushima 770-8502, Japan.
Healthcare (Basel). 2025 Aug 21;13(16):2070. doi: 10.3390/healthcare13162070.
Cesarean section (CS) is a critical surgical procedure in obstetrics but is increasingly overused worldwide. Vietnam has seen rising CS rates, especially in urban tertiary hospitals, with limited standardized analysis to guide interventions. This study assesses CS rates at Tu Du Hospital using the WHO-endorsed Robson 10-Group Classification System. A cross-sectional descriptive study was conducted over one month in 2017 at Tu Du Hospital, a major obstetrics referral center in southern Vietnam. All women who delivered during this period were classified into Robson's 10 groups based on parity, gestational age, labor onset, presentation, fetal number, and prior CS. CS rates and group-specific contributions were analyzed. : Among 5287 deliveries, the overall CS rate was 42.6%. Group 5 (previous CS) contributed 29.7% of all CSs, followed by Group 2 (nulliparous, induced/pre-labor CS, 26.2%) and Group 1 (nulliparous, spontaneous labor, 12.8%). Failed induction, fetal distress, and cephalopelvic disproportion were common indications. Only 22% of eligible women in Group 5 were offered a trial of labor after cesarean (TOLAC), although the success rate for vaginal birth after cesarean (VBAC) was 67%, indicating underutilization of this option. : This study provides rare Robson-based evidence from Vietnam, identifying key target groups for intervention. The findings support expanded use of VBAC and more stringent criteria for induction. Future research should explore behavioral and systemic drivers of high CS rates to guide national policy.
剖宫产是产科一项关键的外科手术，但在全球范围内正日益被过度使用。越南的剖宫产率不断上升，尤其是在城市的三级医院，而用于指导干预措施的标准化分析有限。本研究使用世界卫生组织认可的罗布森十组分类系统评估了图德医院的剖宫产率。2017年，在越南南部主要的产科转诊中心图德医院进行了为期一个月的横断面描述性研究。在此期间分娩的所有妇女根据产次、孕周、临产发动情况、胎位、胎儿数量和既往剖宫产史被分为罗布森的十组。分析了剖宫产率和各特定组别的贡献率。在5287例分娩中，总体剖宫产率为42.6%。第5组（既往剖宫产史）占所有剖宫产的29.7%，其次是第2组（初产妇，引产/临产前剖宫产，26.2%）和第1组（初产妇，自然临产，12.8%）。引产失败、胎儿窘迫和头盆不称是常见的指征。尽管剖宫产术后阴道分娩（VBAC）的成功率为67%，但第5组中只有22%符合条件的妇女接受了剖宫产术后试产（TOLAC），这表明该选择未得到充分利用。本研究提供了来自越南的罕见的基于罗布森分类系统的证据，确定了关键的干预目标群体。研究结果支持扩大VBAC的使用范围以及采用更严格的引产标准。未来的研究应探索剖宫产率高的行为和系统驱动因素，以指导国家政策。
