Analysing Recent Trends in Caesarean Sections at a Tertiary Care Teaching Hospital in South India: Findings from a Clinical Audit Using Robson Criteria

Background: When performed for the indicated reasons, Caesarean section (CS) is a potentially life-saving surgery. In recent years, the rate of CS deliveries has skyrocketed. A CS is not without complications and risk, so its trends in all institutes should be audited to ensure that obstetric care standards are optimised.

Methods: The study was carried out as a retrospective analysis of all CS deliveries over a 12-month period and their categorization using the WHO-recommended Robson ten group classification system, with the goal of evaluating and understanding the indication for each CS performed at the institute. The Robson was further subclassified in order to gain a better understanding of the circumstances under which the CS was performed in each group.

Results: This study looked at a total of 2831 deliveries, with 1557 (55 percent) of them being CS births. 48.5 percent of these CS births were indicated for emergency indications. Class 5, 1, and 10 were the main contributors to the CS rate, accounting for 50.6 percent, 19.3 percent, and 10%, respectively. Only 12.1 percent of 799 patients with previous CS were able to have a successful scar trial. In decreasing order, the most common indications documented for Group 1 were foetal distress, cephalo pelvic disproportion, and prolonged labour. The majority (92.3 percent) of singleton pre-terms who had a CS were operated on before the onset of labour.

Conclusions: The audit assisted in understanding the trends of CS in the institute and in realising that all of the CS in the institute has questionable indications. This resulted in the implementation of clinical and administrative reforms to reduce unnecessary CS.