Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate
of cesarean section varies depending on the country and the health facility. For
this reason, in 2015, the World Health Organization (WHO) recommended the use of
Robson’s classification to evaluate the practice of cesarean sections in order to
identify the groups of women who had abnormally high rates. The objective of our
study was to evaluate cesarean sections using the Robson’s classification in CHRACERH
and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a
retrospective cross sectional and descriptive study in two (02) university hospitals
in Yaoundé which took place from December 2017 to May 2018. We included in our study
all women who gave birth over a period of two (02) years from January 2016 to December
2017 in these two health facilities.Our sampling was exhaustive over
the study period. The parturients’ information was collected using an anonymous and pretested questionnaire.
The Robson’s group of every parturient was determined. Descriptive parameters like
mean and proportions were calculated. We compared the rates and indications of cesarean
sections between the both hospitals using Chi2 test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections; hence,
a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean
section, hence a rate of 24.8%. The women who belonged to groups 1,3 and 5 contributed to the highest rates of cesarean sections in both hospitals:
in CHRACERH, group 5(31.1%), group
References
[1]
OrganisationMondiale de la Santé (2014) Déclaration de l’OMS sur les taux de césarienne.
[2]
Vogel, J.P., Betrán, A.P., Vindevoghel, N., Souza, J.P., Torloni, M.R., Zhang, J., et al. (2015) Use of the Robson Classification to Assess Caesarean Section Trends in 21 Countries: A Secondary Analysis of Two WHO Multicountry Surveys. Lancet Global Health, 3, 260-270. https://doi.org/10.1016/S2214-109X(15)70094-X
[3]
Althabe, F. and Belizan, J.M. (2006) Caesarean Section: The Paradox. Lancet, 368, 1472-1473. https://doi.org/10.1016/S0140-6736(06)69616-5
[4]
National Institutes of Health State-of-the-Science Conference Statement (2006) Cesarean Delivery on Maternal Request. Obstetrics & Gynecology, 107, 1386-1397.
https://doi.org/10.1097/00006250-200606000-00027
[5]
Dobson, R. (2001) Caesarean Section Rate in England and Wales Hits 21%. BMJ, 323, 951. https://doi.org/10.1136/bmj.323.7319.951a
[6]
Births (2016) Method of Delivery. Centers for Disease Control and Prevention.
[7]
Bragg, F., Cromwell, D.A., Edozien, L.C., Gurol-Urganci, I., Mahmood, T.A., Templeton, A., et al. (2010) Variation in Rates of Caesarean Section among English NHS Trusts after Accounting for Maternal and Clinical Risk: Cross Sectional Study. BMJ, 341, e5065. https://doi.org/10.1136/bmj.c5065
[8]
Kemfang, N.J.D., Ngassam, A., Fouogue, J.T., Metogo, J., Medou, A. and Kasia, J.M. (2015) Complications maternelles précoces de la césarienne. The Pan African Medical Journal, 21, 265.
[9]
Hannah, M.E., Hannah, W.J., Hewson, S.A., Hodnett, E.D., Saigal, S. and Willan, A.R. (2000) Planned Caesarean Section versus Planned Vaginal Birth for Breech Presentation at Term: A Randomised Multicenter Trial. Lancet, 356, 1375-1383.
https://doi.org/10.1016/S0140-6736(00)02840-3
[10]
Broche, D.-E., Courtois, L., Maillet, R. and Riethmuller, D. (2008) Césariennes. EMC - Obstétrique, 31, 1-16. https://doi.org/10.1016/S0246-0335(08)45770-8
[11]
Souza, J.P., Gülmezoglu, A., Lumbiganon, P., Laopaiboon, M., Carroli, G., Fawole, B., et al. (2010) Caesarean Section without Medical Indications Is Associated with an Increased Risk of Adverse Short-Term Maternal Outcomes the 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Medicine, 8, Article Number: 71. https://doi.org/10.1186/1741-7015-8-71
[12]
Betrán, A.P., Vindevoghel, N., Souza, J.P., Gülmezoglu, A.M. and Torloni, M.R. (2014) A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn’t Work and How to Improve It. PLOS ONE, 9, e97769.
https://doi.org/10.1371/journal.pone.0097769
[13]
Robson, M.S. (2001) Classification of Caesarean Sections. Fetal and Maternal Medicine Review, 12, 23-39. https://doi.org/10.1017/S0965539501000122
[14]
Mbungu, M.R., Ntela, M.J. and Kahindo, M.P. (2017) Fréquence des césariennes selon la classification de Robson dans 3 maternités de la ville de Kinshasa, en République Démocratique du Congo. Annals of African Medicine, 10, 2535-2544.
[15]
Kinenkinda, X., Mukuku, O., Chenge, F., Kakuddji, P., Banzulu, P., Kakoma, J.B., et al. (2017) Césarienne à Lubumbashi, République Démocratique du Congo II: Facteurs de risque de mortalité maternelle et périnatale. The Pan African Medical Journal, 46, 208. https://doi.org/10.11604/pamj.2017.26.208.12148
[16]
Hehir, M.P., Ananth, C.V., Siddiq, Z., Flood, K., Friedman, A.M. and D’Alton, M.E. (2018) Cesarean Delivery in the United States 2005-2014: A Population-Based Analysis Using the Robson Ten Group Classification System. American Journal of Obstetrics & Gynecology, 229, 105.e1-105.e11.
https://doi.org/10.1016/j.ajog.2018.04.012
[17]
Tura, A.K., Pijpers, O., de Man, M., Cleveringa, M., Koopmans, I., Gure, T., et al. (2018) Analysis of Caesarean Sections Using Robson 10-Group Classification System in a University Hospital in Eastern Ethiopia: A Crosssectional Study. BMJ Open, 8, e020520. https://doi.org/10.1136/bmjopen-2017-020520
[18]
Kazmi, T., Saiseema, S.V. and Khan, S. (2012) Analysis of Cesarean Section Rate According to Robson’s 10-Group Classification. Oman Medical Journal, 27, 415-417.
https://doi.org/10.5001/omj.2012.102
