Analysis of caesarean sections using Robson 10-group classification system in a university hospital in eastern Ethiopia: A cross-sectional study

Objective To analyse caesarean section (CS) using Robson 10-group classification system in an Ethiopian university hospital. Design Cross-sectional study. Setting A university hospital in eastern, Ethiopia. Participants 980 women who underwent CS from January 2016 to April 2017. Main outcome Robson groups (1-10 - based on gestational age, fetal presentation, number of fetus, onset of labour and history of CS) and indications for CS. Results Robson group 3 (multiparous women with single cephalic full-term pregnancy in spontaneous labour with no history of CS), group 5 (multiparous women with single cephalic full-term pregnancy with history of CS) and group 1 (single cephalic nulliparous women full-term pregnancy in spontaneous labour) were the major contributors to the overall CS at 21.4%, 21.1% and 19.3%, respectively. The three major indications for CS were fetal compromise (mainly fetal distress), obstructed labour (mainly cephalopelvic disproportion) and previous CS. Conclusion Robson groups 3, 5 and 1 were the major contributors to the overall CS rate. Fetal compromise, obstructed labour and previous CS were the underlying indications for performing CS. Further study is required to assess the appropriateness of the indications and to reduce CS among the low-risk groups (groups 1 and 3).