High Time for Routine Implementation of the Robson Ten-Group Classification for Cesarean Sections Reporting in India!!!
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LETTER TO THE EDITOR
High Time for Routine Implementation of the Robson Ten‑Group Classification for Cesarean Sections Reporting in India!!! Divya Pandey1 Received: 21 May 2020 / Accepted: 6 October 2020 © Federation of Obstetric & Gynecological Societies of India 2020
This is in reference to the article titled “Trend Prediction for Cesarean Deliveries Based on Robson Classification System at a Tertiary Referral Unit of North India” published in your esteemed journal in March–April, 2020 issue. 1 In 1985, World Health Organization (WHO) made a remark regarding cesarean delivery (CS) rate and suggested that it should not be more than 10–15%. CS rates have risen from what the “ideal rate” should be to a rate which needs to be proved apposite considering the pros and cons of cesarean delivery in modern Obstetrics. Nowadays, the Obstetricians are being increasingly accused as a factor behind this rate hike. In view of striking improvement in clinical Obstetrics outcome, there is rising demand by the clinicians for re-appraisal of the existing recommended rate proposed by WHO. The cited article has audited cesarean deliveries using Robson system on a very huge database and also predicted future trend based on the same giving an opportunity to plan and check in advance, the major contributory populations to cesarean deliveries. The Robson Ten-Group Classification System (TGCS) proposed by Michael Robson (2001) is a simple, reliable, globally applicable system to gather standardized data across the international boundaries for easy comparisons. Thus, it can enable us to determine adequate CS rate which was definitely a great challenge till now. TGCS is a standard classification system of ten mutually exclusive (hence preventing data duplication) and comprehensive classes, allowing easy
Dr. Divya Pandey (MS, FICOG, FICMCH) is an Associate Professor at Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India. * Divya Pandey [email protected] 1
Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
analysis. This classification can be used for local/regional/ national/international comparisons. It categorizes women according to very basic Obstetric characteristics (data) which are routinely collected at all Obstetrics center. Hence, it allows comparisons with the least confounding variables. These are parity (primi/multiparous, with or without previous cesarean section), onset of labor (spontaneous/induced or pre-labor CS), gestational age (preterm/term), fetal presentation (cephalic/breech/ transverse) and number of fetuses (single/multiple). This is further divided into ten groups which can easily allow intergroup and intragroup comparison and analysis. An expert panel meeting convened by WHO at Geneva in October 2014 has recommended the routine application of Robson classification to categorize every woman admitted for delivery and whenever possible the results should be made
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