Cesarean rates according to the Robson classification: analysis in a municipal maternity in São Paulo

ABSTRACT Objective To investigate the distribution of parturients at Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho according to the Robson classification, identify the cesarean rate in each Robson Group, and understand which group contributes more to the prevalence of Cesarean sections. Methods This is a retrospective observational cross-sectional study conducted through the analysis of medical records of parturients admitted to Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho from October 2016 to August 2019. Results A total of 9,794 births were recorded, and 31% were by Cesarean section. The most prevalent Robson Groups were Group 3 (25.7%-2,519), 1 (22.8%-2,234), and 5 (20.5%-2,006). The relative contribution of Cesarean sections was greatest in Groups 5 (39%), 2 (18%), and 1 (12.5%). Conclusion This study demonstrated the Robson classification is useful to lead to a more critical view, identifying the groups that deserve more attention, since they are the major contributors to cesarean rates; hence, the management protocols could be modified aim to reduce cesarean rates.

摘要
研究目的：本研究旨在依据罗布森分类法（Robson classification），对圣卡塔琳娜维拉市立吉尔松·德·卡西亚·马尔克斯·德·卡瓦略医院（Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho）内产妇的分布情况开展调查，明确各罗布森分组的剖宫产率，并明晰哪一组对剖宫产术的整体占比贡献最大。
研究方法：本研究为回顾性观察性横断面研究，分析了2016年10月至2019年8月期间于上述医院收治的产妇的病历资料。
研究结果：本次研究共记录9794例分娩，其中31%为剖宫产术分娩。占比最高的三组罗布森分组依次为第3组（25.7%，共2519例）、第1组（22.8%，共2234例）及第5组（20.5%，共2006例）。剖宫产术的相对贡献占比最高的分组依次为第5组（39%）、第2组（18%）及第1组（12.5%）。
研究结论：本研究证实，罗布森分类法有助于形成更严谨的审视视角，可识别出需重点关注的分组——这些分组正是剖宫产率的主要贡献来源；因此可通过调整临床管理方案以降低剖宫产率。