Investigating Caesarean Section Practice among Teenage Romanian Mothers Using Modified Robson Ten Group Classification System

Alexandra Matei, Mihai Cornel Dimitriu, George Alexandru Roșu, Cristian George Furău and Crîngu Antoniu Ionescu
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Alexandra Matei: Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Doctoral School, 020021 Bucharest, Romania
Mihai Cornel Dimitriu: Department of Obstetrics and Gynecology, “Sf. Pantelimon” Emergency Clinical Hospital, 021659 Bucharest, Romania
George Alexandru Roșu: Department of Obstetrics and Gynecology, “Sf. Pantelimon” Emergency Clinical Hospital, 021659 Bucharest, Romania
Cristian George Furău: Department of Obstetrics and Gynecology, Faculty of Medicine, “Vasile Goldiș” Western University of Arad, 310025 Arad, Romania
Crîngu Antoniu Ionescu: Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy Doctoral School, 020021 Bucharest, Romania

IJERPH, 2021, vol. 18, issue 20, 1-13

Abstract: The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different ( p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.

Keywords: Robson classification; caesarean section; caesarean indication; adolescent birth; pregnant women (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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