Robson classification of Caesarean sections at the Federal Medical Centre, Makurdi

Abstract

Objective: The Robson classification system is a global standard for assessing, monitoring and comparing Caesarean Section rates (CSR). The objective of the study was to classify CS according to Robson's classification with the view to reducing the rising CS rate in Nigeria. Methodology: A cross-sectional study of Robson classification of CS at the FMC Makurdi, from 1st January 2018 to 31st October 2019 using the 10 Robson’s groups based on six obstetric characteristics that are routinely documented: parity, previous CS, the onset of labour, gestational age, fetal lie/presentation, and number of foetuses using routine labour ward and theatre registers. Results: Out of the 4,075 women studied, 989 were CS giving a CSR of 24.3%. Seven of these CS could not be classified into a Robson group because of uncertainty of gestational age. The groups with the greatest impact on CS rate Groups 5, 1 and 3. Group 5 accounted for 30.1% of the CSs. The second group that contributed most to the CSR in the study was Group 1 which accounted for 28.1% of all C/Ss. Group 3 contributed 12.8% of the CSs. Conclusion: The caesarean section rate in this study is higher than the recommended global average. This calls for efforts to reduce the CSR. Vaginal birth after Caesarean section and induction of labour for primigravida for selected cases, are recommended interventions to reduce the rising caesarean section rate in Nigeria.