Escorial AR, Ruiz FI, Rosales TC, Marín CM

Language: Spanish
References: 22
Page: 1-11
PDF size: 502.88 Kb.

ABSTRACT

Introduction: Caesarean section is the most used obstetric surgical risky procedure, which means that we must look for methods to control that it is performed only in those cases in which it is really indicated.
Objectives: To analyze the rate of cesarean sections in groups of patients according to the Robson classification, and the correlation between the increase in the average age of pregnant women and the rate of cesarean sections found.
Methods: Retrospective descriptive observational analysis of the total number of deliveries in pregnant women aged 40 years or older and with gestational age at delivery higher than 22 + 0 assisted at Virgen del Rocío University Hospital in Seville, from 1 January 2017 to December 31, 2018. The obstetric results of 791 pregnant women who met the inclusion criteria were analyzed, subdivided according to the different categories of Robson classification.
Results: The results showed predominance in groups 5 (pregnant women with previous cesarean sections) and 2 (induction of labor or elective cesarean section in nulliparous women).
Conclusions: The overall rate of cesarean sections in the study population was 36.9%, which is a much higher rate than that established by the World Health Organization as recommended.

REFERENCES

1. Janoudi G, Kelly S, Yasseen A, Hamam H, Moretti F, Walker M. Factors Associated with Increased Rates of Caesarean Section in Women of Advanced Maternal Age. J Obstet Gynaecol Canada. 2015;37(6):517-26. DOI: http://dx.doi.org/10.1016/S1701-2163(15)30228-0

2. Gerli S, Favilli A, Franchini D, De Giorgi M, Casucci P, Parazzini F. Is the Robson’s classification system burdened by obstetric pathologies, maternal characteristics and assistential levels in comparing hospitals cesarean rates? A regional analysis of class 1 and 3. J Matern Neonatal Med. 2018;31(2):173-7. DOI: http://dx.doi.org/10.1080/14767058.2017.1279142

3. Toneut CM, Elena IM, García G, Alina II, Vega M, Fernández RB, et al. Resultados maternos y perinatales en gestantes con avanzada edad materna. Rev Cuba Obstet Ginecol. 2017 [acceso 12/08/2019];43(2):1-14. Disponible en: https://scielo.sld.cu

4. Rozen G, Ugoni AM, Sheehan PM. A new perspective on VBAC: A retrospective cohort study. Women and Birth. 2011;24(1):3-9. DOI: http://dx.doi.org/10.1016/j.wombi.2010.04.001

5. Baghurst P, Robson S, Antoniou G, Scheil W, Bryce R. The association between increasing maternal age at first birth and decreased rates of spontaneous vaginal birth in South Australia from 1991 to 2009. Aust New Zeal J Obstet Gynaecol. 2014;54(3):237-43.

6. Robson MS. The 10-Group Classification System–a new way of thinking. Am J Obstet Gynecol. 2018;219(1):1-4. DOI: https://doi.org/10.1016/j.ajog.2018.05.026

7. Robson MS. Can we reduce the caesarean section rate? Best Pract Res Clin Obstet Gynaecol. 2001;15(1):179-94.

8. Bermúdez-Tamayo C, Fernández Ruiz E, Pastor Moreno G, Maroto-Navarro G, Garcia-Mochon L, Perez-Ramos FJ, et al. Barriers and enablers in the implementation of a program to reduce cesarean deliveries. Reprod Health. 2017;14(1):1-13.

9. Hernández-Martínez A, Pascual-Pedreño AI, Baño-Garnés AB, Melero-Jiménez MR, Tenías-Burillo JM, Molina-Alarcón M. Predictive model for risk of cesarean section in pregnant women after induction of labor. Arch Gynecol Obstet. 2016;293(3):529-38.

10. OMS. Clasificación de Robson: Manual de aplicación. Washington, D.C.: Organización Mundial de la Salud; 2018. p. 12.

11. Robson MS. Use of indications to identify appropriate caesarean section rates. Lancet Global Health. 2018;6(8):20-1. DOI: https://doi.org/10.1016/S2214-109X(18)30319-X

12. FIGO Statement. Best practice advice on the 10-Group Classification: System for cesarean deliveries. FIGO Working Group on Challenges in Care of Mothers and infants during Labour and Delivery. Int J Gynecol Obs. 2016;135:232-3.

13. Betran AP, Torlini MR, Zhang JJ GA. WHO Working Group on Caesarean Section. BJOG. 2016 [acceso 12/08/2019];123(5):667-70. Disponible en: https://pubmed.ncbi.nlm.nih.gov

14. Robson MS. Classification of caesarean sections. Fetal Matern Med Rev. 2001;12(1):23-9.

15. Servicio CGL and FGR. Implementation of the Robson 10-Group Classification System at Hospital de Manises: Optimization of the cesarean delivery rate. Prog Obstet Ginecol. 2018;61(1):16-21.

16. Valldeperas Abad L, Altés Planas A, Cobos Melià M, Furriols Raulí B. Rate of cesarean delivery according to the Robson classification at Hospital de Mataró. Prog Obstet Ginecol. 2018;61(2):136-40.

17. Einarsdóttir K, Sigurðardóttir H, Ingibjörg Bjarnadóttir R, Steingrímsdóttir Þ, Smárason AK. The Robson 10-group classification in Iceland: Obstetric interventions and outcomes. Birth. 2019;46(2):270-8.

18. Vargas S, Rego S, Clode N. Robson Classification System Applied to Induction of Labor TT - Classificação de Robson aplicada à indução do trabalho de parto. Rev Bras Ginecol Obstet. 2018 [acceso 12/08/2019];40(9):513-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/30071570

19. Simó González M, Calaf Alsina J, Terribas Sala N, Luqui Scarcelli N, Plana Borrás J, Polo Ramos A. Pregnancy beyond 65: report of a unique case and discussion of a controversial issue. Eur J Contracept Reprod Health Care. 2016;21(6):496-8. DOI: http://dx.doi.org/10.1080/13625187.2016.1234599

20. Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR ZJ. WHO Multi-Country Survey on Maternal and Newborn Health Research Network. Use of the Robson classification to assess caesarean section trends in 21 countries: A secondary analysis of two WHO multicountry surveys. Lancet Global Health. 2015;3(5):60-70.

21. Betran AP, Vindevoghel N, Souza JP, Gülmezoglu AM TM. A systematic review of the Robson classification for caesarean section: What works, doesn’t work and how to improve it. PLoS One. 2014;9(6):97769.

22. Canto MJ, Reus A, Cortés S, Ojeda F. Pregnancy outcome in a Spanish population of women beyond age 40 delivered above 32 weeks’ gestation. J Matern Neonatal Med. 2012;25(5):461-6.