Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study
Objective Caesarean section (CS) rates have increased worldwide in recent decades. In 2015, the WHO proposed the use of the 10-group Robson classification as a global standard for assessing, monitoring and comparing CS rates both within healthcare facilities over time and between them. The aim of th...
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BMJ Publishing Group
2019-12-01
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| author | Ana Pilar Betran Giovanni Putoto Francesca Tognon Donald Maziku Angela Borghero Giovanni Fernando Torelli Gaetano Azzimonti |
| author_facet | Ana Pilar Betran Giovanni Putoto Francesca Tognon Donald Maziku Angela Borghero Giovanni Fernando Torelli Gaetano Azzimonti |
| author_sort | Ana Pilar Betran |
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| description | Objective Caesarean section (CS) rates have increased worldwide in recent decades. In 2015, the WHO proposed the use of the 10-group Robson classification as a global standard for assessing, monitoring and comparing CS rates both within healthcare facilities over time and between them. The aim of this study was to assess the pattern of CS rates according to the Robson classification and describe maternal and perinatal outcomes by group at the Tosamaganga Hospital in rural Tanzania.Design Observational retrospective study.Setting St. John of the Cross Tosamaganga Hospital, a referral centre in rural Tanzania.Participants 3012 women who gave birth in Tosamaganga Hospital from 1 January to 30 June 2014 and from 1 March to 30 November 2015.Results The overall CS rate was 35.2%, and about 90% of women admitted for labour were in Robson groups 1 through 5. More than 40% of the CS carried out in the hospital were performed on nulliparous women at term with a single fetus in cephalic presentation (groups 1 and 3), and the most frequent indication for the procedure was previous uterine scar (39.2%). The majority of severe neonatal outcomes were observed in groups 1 (27.7%), 10 (24.5%) and 3 (19.1%).Conclusion We recorded a high CS rate in Tosamaganga Hospital, particularly in low-risk patients groups (Robson groups 1 and 3). Our analysis of Robson classification and neonatal outcomes suggests the need to improve labour management at the hospital and to provide timely referrals in order to prevent women from arriving there in critical conditions. |
| format | Article |
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| institution | DOAJ |
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| language | English |
| publishDate | 2019-12-01 |
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| spelling | doaj-art-e217ceaf4a0e4250ba15abdc06b7d1792025-08-20T02:49:13ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-033348Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective studyAna Pilar Betran0Giovanni Putoto1Francesca Tognon2Donald Maziku3Angela Borghero4Giovanni Fernando Torelli5Gaetano Azzimonti6UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO, Geneva, SwitzerlandDoctors with Africa, CUAMM, Kampala, UgandaDoctors with Africa CUAMM, Padua, Italy4 Maternity Department, Tosamaganga Council Designated Hospital, Iringa, United Republic of Tanzania3 Tosamaganga Council Designated Hospital, Cuamm Medici con l`Africa, Iringa, United Republic of Tanzania3 Tosamaganga Council Designated Hospital, Cuamm Medici con l`Africa, Iringa, United Republic of Tanzania3 Tosamaganga Council Designated Hospital, Cuamm Medici con l`Africa, Iringa, United Republic of TanzaniaObjective Caesarean section (CS) rates have increased worldwide in recent decades. In 2015, the WHO proposed the use of the 10-group Robson classification as a global standard for assessing, monitoring and comparing CS rates both within healthcare facilities over time and between them. The aim of this study was to assess the pattern of CS rates according to the Robson classification and describe maternal and perinatal outcomes by group at the Tosamaganga Hospital in rural Tanzania.Design Observational retrospective study.Setting St. John of the Cross Tosamaganga Hospital, a referral centre in rural Tanzania.Participants 3012 women who gave birth in Tosamaganga Hospital from 1 January to 30 June 2014 and from 1 March to 30 November 2015.Results The overall CS rate was 35.2%, and about 90% of women admitted for labour were in Robson groups 1 through 5. More than 40% of the CS carried out in the hospital were performed on nulliparous women at term with a single fetus in cephalic presentation (groups 1 and 3), and the most frequent indication for the procedure was previous uterine scar (39.2%). The majority of severe neonatal outcomes were observed in groups 1 (27.7%), 10 (24.5%) and 3 (19.1%).Conclusion We recorded a high CS rate in Tosamaganga Hospital, particularly in low-risk patients groups (Robson groups 1 and 3). Our analysis of Robson classification and neonatal outcomes suggests the need to improve labour management at the hospital and to provide timely referrals in order to prevent women from arriving there in critical conditions.https://bmjopen.bmj.com/content/9/12/e033348.full |
| spellingShingle | Ana Pilar Betran Giovanni Putoto Francesca Tognon Donald Maziku Angela Borghero Giovanni Fernando Torelli Gaetano Azzimonti Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study BMJ Open |
| title | Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study |
| title_full | Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study |
| title_fullStr | Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study |
| title_full_unstemmed | Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study |
| title_short | Analysis of caesarean section and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study |
| title_sort | analysis of caesarean section and neonatal outcome using the robson classification in a rural district hospital in tanzania an observational retrospective study |
| url | https://bmjopen.bmj.com/content/9/12/e033348.full |
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