Analysis of cesarean delivery at Assiut University Hospital using the Ten Group Classification System

Abstract Objective To evaluate the feasibility of using the Robson Ten Group Classification System (TGCS) for cesarean delivery (CD) indications at institutional level. Methods Prospective clinical audits of women delivering by CD at Women’s Health Hospital, Assiut, Egypt, were conducted in 2008 and 2011. The CD rates overall and in each Robson group were calculated, as was the contribution of each group to the overall CD rate. In addition, the CD indications in each group were analyzed. Results The CD rate was 32% (443/1357) in 2008 and 38% (626/1628) in 2011. The most common CD indication at both time intervals was a previous CD. Multiparas without uterine scar, a single cephalic term pregnancy, and spontaneous labor (Robson Group 3) comprised the largest group of women undergoing CD, followed by nulliparas with a single cephalic term pregnancy and spontaneous labor (Group 1), and multiparas with a scarred uterus and a single cephalic term pregnancy (Group 5). Group 5 was the largest contributor (30%) to the overall CD rate, followed by Groups 1 and 4 (10% each). Conclusion The TGCS can be applied at institutional level. It helps in planning strategies for specific subgroups of women to reduce CD rates and improve outcomes.