Analysis of Caesarean Section Rate According to the Robson Classification System
NCT ID: NCT03794063
Last Updated: 2019-07-18
Study Results
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Basic Information
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UNKNOWN
3000 participants
OBSERVATIONAL
2019-03-10
2019-08-01
Brief Summary
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Detailed Description
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Policy makers and health organisations have suggested the need for such classification system that can best monitor and compare CS rates in a standardised, reliable, consistent and action-oriented manner. WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS. It gives an opportunity to evaluate the prevalence of CSs among various groups of women, to compare data between institutions, learn from each other and to create strategies for better results through audit and feed back cycle. This classification is clinically relevant and categorizes women prospectively which in turns allows the implementation and evaluation of interventions targeted to specific groups. Some studies have shown that if this classification is used on a regular basis, it can provide critical assessment to change the practice.
Aim: The study aim is, to assess, analyse and compare CSR of the participating hospital over the period of three months according to the 10 Group Robson classification system
Participating hospitals
1: Ain Shams University Hospital 4: Mataria Teaching Hospital 4: Shatby Alexandria Hospital 5: Benha University Hospital 6: Ahmed Maher Hospital 7: El-Galaa Hospital 8: Alexandria Hospital 9: Behira Hospital 10:Menia Hospital 11: Luxor Hospital 12: Nada Hospital 13: Rofayda Hospital
Study design: A prospective cross- sectional study will be conducted to implement the Robson Classification within the obstetric department of participating hospitals. The Robson implementation manual will be used as a tool guide for the study.
The study population will include all women with live births and stillbirths of at least 28 weeks gestation at from. Two-study investigator from each participating hospital will be assigned who will provide the ongoing support during the study period. Participants will be invited to attend the introductory workshop for the implementation of the Robson Classification by the study coordinators. Variables necessary to categorise women in to Robson groups will be collected through the predesigned proforma. These variables will be used to classify each woman in to Robson groups with the help of a flow diagram. The collected information will be analyzed on the Excel Sheet to finalize the grouping either manually or by an automatic calculator.The results of each group will be statistically analyzed after entering the data in the report and will be sent on a monthly basis by e-mail or fax to study coordinators.
Conditions
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Study Design
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OTHER
CROSS_SECTIONAL
Study Groups
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Robson group 1
Nulliparous women, single cephalic, more than or equal to 37 weeks, in spontaneous labour
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 2
Nulliparous women, single cephalic, more than or equal to 37 weeks, induced or Caesarean section before labour
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 3
Multiparous women with out a previous Caesarean section , with a single cephalic pregnancy, more than or equal 37 weeks gestation in spontaneous labour
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 4
Multiparous women with out a previous Caesarean section , with a single cephalic pregnancy, more or equal 37 weeks gestation who had labour induced or were delivered by Caesarean section before labour
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 5
All Multiparous women with at least one CS with a single cephalic pregnancy, more or equal to 37 weeks gestation
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 6
All nulliparous women with a single breech pregnancy
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 7
Multiparous women with a single breech pregnancy including women with previous Caesarean section
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 8
All women with multiple pregnancies including women with previous Caesarean sections
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 9
All women with a single pregnancy with a transverse or oblique lie, including women with previous Caesarean Section (s)
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Robson Group 10
All women with a single cephalic pregnancy less than 37 weeks gestation, including women with previous Caesarean section (s)
Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Interventions
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Robson 10 group classification system
WHO proposed the Robson classification system as a global standard for assessing, monitoring and comparing caesarean section rates within healthcare facilities over time, and between facilities. It classifies women in 10 groups based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) without needing the indication for CS.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
FEMALE
No
Sponsors
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Egyptian Society of Royal College of Obstetricians and Gynaecologists
OTHER
Responsible Party
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Dr Bismeen Jadoon
Research coordinator
Locations
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Egyption society of Royal college of obstetricians and gynaecologist
Cairo, , Egypt
Countries
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Central Contacts
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Facility Contacts
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References
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Appropriate technology for birth. Lancet. 1985 Aug 24;2(8452):436-7.
Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016 Feb 5;11(2):e0148343. doi: 10.1371/journal.pone.0148343. eCollection 2016.
Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, Merialdi M. Classifications for cesarean section: a systematic review. PLoS One. 2011 Jan 20;6(1):e14566. doi: 10.1371/journal.pone.0014566.
Betran AP, Vindevoghel N, Souza JP, Gulmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it. PLoS One. 2014 Jun 3;9(6):e97769. doi: 10.1371/journal.pone.0097769. eCollection 2014.
Robson MS (2001) Classification of caesarean sections. Fetal and Maternal Medicine Review 12: 23-39.
Robson M, Hartigan L, Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol. 2013 Apr;27(2):297-308. doi: 10.1016/j.bpobgyn.2012.09.004. Epub 2012 Nov 3.
Boatin AA, Cullinane F, Torloni MR, Betran AP. Audit and feedback using the Robson classification to reduce caesarean section rates: a systematic review. BJOG. 2018 Jan;125(1):36-42. doi: 10.1111/1471-0528.14774. Epub 2017 Jul 17.
Chaillet N, Dumont A. Evidence-based strategies for reducing cesarean section rates: a meta-analysis. Birth. 2007 Mar;34(1):53-64. doi: 10.1111/j.1523-536X.2006.00146.x.
Related Links
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Egypt Demographic Health Survey (DHS) , 2014
Other Identifiers
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ERC-RCOG
Identifier Type: -
Identifier Source: org_study_id
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