Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance
BACKGROUND: The worldwide increase in the cesarean delivery rate is a major public health concern and cause of significant debate. Although multiple studies have shown that higher cesarean delivery rates may be associated with adverse maternal and perinatal outcomes, the number of cesarean deliverie...
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Elsevier
2024-11-01
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| author | Angela Marian-Pavlenco, MD, PhD Irina Siritanu, MD Tatiana Ribac, MD Valentin Friptu, MD, PhD |
| author_facet | Angela Marian-Pavlenco, MD, PhD Irina Siritanu, MD Tatiana Ribac, MD Valentin Friptu, MD, PhD |
| author_sort | Angela Marian-Pavlenco, MD, PhD |
| collection | DOAJ |
| description | BACKGROUND: The worldwide increase in the cesarean delivery rate is a major public health concern and cause of significant debate. Although multiple studies have shown that higher cesarean delivery rates may be associated with adverse maternal and perinatal outcomes, the number of cesarean deliveries has been continuously increasing. In the Republic of Moldova, cesarean delivery increased from 15.75% in 2012 to 27.42% in 2022. However, the perinatal mortality remained unchanged at 11.6%. To understand the factors that determine the increasing trend in cesarean delivery and to approach new strategies to reduce unnecessary surgical delivery, a standardized tool is needed to assess and compare cesarean delivery rates. OBJECTIVE: This study aimed to assess the changes in the rates and trends of cesarean delivery and to evaluate the contribution of different obstetrical populations to overall cesarean delivery rates in the Municipal Clinical Hospital using the Robson classification. STUDY DESIGN: This was a cohort study conducted at the Municipal Clinical Hospital in Chisinau. The study included 13,882 women who gave birth in 2017, 2019, and 2022 at the Municipal Clinical Hospital. All births were classified into 10 Robson groups, using 6 basic variables (parity, cesarean delivery in medical history, labor onset, number of fetuses, gestational age, and fetal presentation). Statistical data were collected and analyzed using the Epi Info program (version 7.2.1.0; Centers for Disease Control and Prevention, Atlanta, GA). RESULTS: The overall cesarean delivery rate was 20.02% (2779/13,882), with a significant increase from 18.59% (809/4351) to 21.59% (1134/5252) (P=.0003). Approximately one-third (1099/2279 [39.55%]) of all cesarean deliveries were performed before labor onset. The main contributor in all study years was group 5 (957/2779 [34.44%]). The next valuable group that contributed to the overall cesarean delivery rate was group 2 (393/2779 [14.14%]), followed by group 1 (333/2779 [11.98%]). CONCLUSION: The Robson Ten-Group Classification System provides a clear and detailed record of the trends in cesarean delivery. In addition, because of the Robson Ten-Group Classification System's simplicity and exclusivity, it can be implemented in the Republic of Moldova. The main contributors to the overall cesarean delivery rate were women with a previous cesarean delivery (group 5), followed by nulliparous women of group 2 and group 1. |
| format | Article |
| id | doaj-art-b538609a6f6b44c7b251f4e625c192be |
| institution | OA Journals |
| issn | 2666-5778 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
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| spelling | doaj-art-b538609a6f6b44c7b251f4e625c192be2025-08-20T01:56:20ZengElsevierAJOG Global Reports2666-57782024-11-014410040810.1016/j.xagr.2024.100408Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a GlanceAngela Marian-Pavlenco, MD, PhD0Irina Siritanu, MD1Tatiana Ribac, MD2Valentin Friptu, MD, PhD3Division of Obstetrics, Gynecology, and Human Reproduction, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.Corresponding author: Irina Siritanu, MD.; Division of Obstetrics, Gynecology, and Human Reproduction, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.Division of Obstetrics, Gynecology, and Human Reproduction, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.Division of Obstetrics, Gynecology, and Human Reproduction, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.BACKGROUND: The worldwide increase in the cesarean delivery rate is a major public health concern and cause of significant debate. Although multiple studies have shown that higher cesarean delivery rates may be associated with adverse maternal and perinatal outcomes, the number of cesarean deliveries has been continuously increasing. In the Republic of Moldova, cesarean delivery increased from 15.75% in 2012 to 27.42% in 2022. However, the perinatal mortality remained unchanged at 11.6%. To understand the factors that determine the increasing trend in cesarean delivery and to approach new strategies to reduce unnecessary surgical delivery, a standardized tool is needed to assess and compare cesarean delivery rates. OBJECTIVE: This study aimed to assess the changes in the rates and trends of cesarean delivery and to evaluate the contribution of different obstetrical populations to overall cesarean delivery rates in the Municipal Clinical Hospital using the Robson classification. STUDY DESIGN: This was a cohort study conducted at the Municipal Clinical Hospital in Chisinau. The study included 13,882 women who gave birth in 2017, 2019, and 2022 at the Municipal Clinical Hospital. All births were classified into 10 Robson groups, using 6 basic variables (parity, cesarean delivery in medical history, labor onset, number of fetuses, gestational age, and fetal presentation). Statistical data were collected and analyzed using the Epi Info program (version 7.2.1.0; Centers for Disease Control and Prevention, Atlanta, GA). RESULTS: The overall cesarean delivery rate was 20.02% (2779/13,882), with a significant increase from 18.59% (809/4351) to 21.59% (1134/5252) (P=.0003). Approximately one-third (1099/2279 [39.55%]) of all cesarean deliveries were performed before labor onset. The main contributor in all study years was group 5 (957/2779 [34.44%]). The next valuable group that contributed to the overall cesarean delivery rate was group 2 (393/2779 [14.14%]), followed by group 1 (333/2779 [11.98%]). CONCLUSION: The Robson Ten-Group Classification System provides a clear and detailed record of the trends in cesarean delivery. In addition, because of the Robson Ten-Group Classification System's simplicity and exclusivity, it can be implemented in the Republic of Moldova. The main contributors to the overall cesarean delivery rate were women with a previous cesarean delivery (group 5), followed by nulliparous women of group 2 and group 1.http://www.sciencedirect.com/science/article/pii/S2666577824001023Ten-group classificationcesarean deliveryRepublic of MoldovaRobson classificationtertiary institutionvaginal delivery |
| spellingShingle | Angela Marian-Pavlenco, MD, PhD Irina Siritanu, MD Tatiana Ribac, MD Valentin Friptu, MD, PhD Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance AJOG Global Reports Ten-group classification cesarean delivery Republic of Moldova Robson classification tertiary institution vaginal delivery |
| title | Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance |
| title_full | Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance |
| title_fullStr | Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance |
| title_full_unstemmed | Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance |
| title_short | Cesarean delivery in a tertiary institution of the Republic of Moldova: analysis using the Robson classificationAJOG Global Reports at a Glance |
| title_sort | cesarean delivery in a tertiary institution of the republic of moldova analysis using the robson classificationajog global reports at a glance |
| topic | Ten-group classification cesarean delivery Republic of Moldova Robson classification tertiary institution vaginal delivery |
| url | http://www.sciencedirect.com/science/article/pii/S2666577824001023 |
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