Gestational Risk as a Determining Factor for Cesarean Section according to the Robson Classification Groups

Abstract

Objective To analyze and compare the frequency of cesarean sections and vaginal deliveries through the Robson Classification in pregnant women attended at a tertiary hospital in two different periods.

Methods Cross-sectional, retrospective study of birth records, comprising 4,010 women, conducted from January 2014 to December 2015 in the only public regional referral hospital for the care of high- risk pregnancies, located in Southern Brazil.

Results The overall cesarean section rate reached 57.5% and the main indication was the existence of a previous uterine cesarean scar. Based on the Robson Classification, groups 5 (26.3%) and 10 (17.4%) were the most frequent ones. In 2015, there was a significant increase in the frequency of groups 1 and 3 (p < 0.001), when compared with the previous year, resulting in an increase in the number of vaginal deliveries (p < 0.0001) and a reduction in cesarean section rates.

Conclusion The Robson Classification proved to be a useful tool to identify the profile of parturients and the groups with the highest risk of cesarean sections in different periods in the same service. Thus, it allows monitoring in a dynamic way the indications and delivery routes and developing actions to reduce cesarean rates according to the characteristics of the pregnant women attended.

Resumo

Objetivo Analisar e comparar a frequência de partos cesáreos e vaginais através da classificação de Robson em gestantes atendidas em um hospital terciário em dois períodos distintos.

Métodos Estudo transversal retrospectivo de registros de nascimento, compreendendo 4.010 mulheres, realizado de janeiro de 2014 a dezembro de 2015 no único hospital público de referência regional para atendimento de gestações de alto risco, localizado no sul do Brasil. A via de parto foi avaliada e as mulheres foram classificadas de acordo com a Classificação de Robson.

Resultados A taxa geral de cesariana foi de 57,5% e a principal indicação foi a existência de cicatriz uterina por cesariana prévia. Quando aplicada a Classificação de Robson, os grupos mais frequentes foram o 5 (26,3%) e o 10 (17,4%). No ano de 2015, ocorreu um aumento significativo da frequência dos grupos 1 e 3 (p < 0,001), quando comparado ao ano anterior, resultando em aumento do número de partos vaginais (p < 0,0001) e redução das taxas de cesariana.

Conclusão A Classificação de Robson mostra ser uma ferramenta útil para identificar o perfil das parturientes e os grupos com maior risco de cesariana em diferentes períodos em um mesmo serviço. Desta forma, permite monitorar de forma dinâmica as indicações e vias de parto e desenvolver ações para redução das taxas de cesariana conforme as características das gestantes atendidas.

Keywords

pregnancy - high-risk pregnancy - parturition - cesarean section - robson classification

Palavras-chave

gestação - gravidez de risco - trabalho de parto - cesárea - classificação de robson

Contributors

All authors participated in the concept and design of the present study; analysis and interpretation of data; drafting or revising of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publication History

Received: 08 January 2020

Accepted: 13 August 2020

Article published online:
19 January 2021

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