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Classification of primary caesarean sections in labor and its usefulness for analysis of Slovenian perinatal data


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Classification of caesarean section in labour.

Foetal distress (no oxytocin)
DystociaInefficient uterine action (cervical dilatation <1 cm/h)Poor response (maximum dose reached) *
Inability to reach maximum dose due to foetal intolerance
Inability to reach maximum dose because of over-contracting or not following unit protocol
Efficient uterine action (cervical dilatation >1cm/h)Cephalopelvic disproportion
Malposition (e.g. occipito posterior)

Maternal and neonatal outcomes (corrected for lethal congenital malformations) in Group 1 (Robson’s Ten Group Classification System – nulliparous women with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses) in 14 maternity units in Slovenia in years 2013 and 2014.

OutcomeMaternity unit
1234567891011121314over all
3rd or 4th degree1 (0.3%)3 (0.2%)10 (1.8%)1 (0.2%)5 (0.4%)3.9 (1.1%)11 (0.8%)3 (0.4%)1 (0.2%)6 (0.7%)4 (0.3%)1 (0.2%)2 (0.3%)3 (0.8%)90 (0.7%)
perineal tear*
PPH >500ml*9 (2.8%)6 (0.4%)41 (7.2%)3 (0.6%)4 (0.4%)227 (6.2%)9 (0.6%)3 (0.4%)4 (1.0%)20 (2.4%)42 (3.6%8 (1.3%)36 (6.1%)3 (0.8%)415 (3.0%)
Transfusion*2 (0.6%)0 (0.0%)2 (0.4%)0 (0.0%)0 (0.0%)18 (0.5%)1 (0.1%)1 (0.1%)0 (0.0%)1 (0.1%)0 (0.0%)3 (0.5%)0 (0.0%)0 (0.0%)28 (0.2%)
Neonatal mortality0 (0.0%)0 (0.0%)1 (0.2%)0 (0.0%)0 (0.0%)1 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)1 (0.3%)3 (0.0%)
Apgar <7 at 5’*1 (0.3%)0 (0.0%)1 (0.2%)1 (0.2%)6 (0.5%)19 (0.5%)8 (0.6%)1 (0.1%)5 (1.2%)2 (0.2%)2 (0.2%)1 (0.2%)2 (0.3%)3 (0.8%)52 (0.4%)
Perinatal asphyxia*8 (2.4%)5 (0.4%)1 (0.2%)0 (0.0%)16 (1.4%)30 (0.8%)1 (0.1%)2 (0.3%)12 (2.9%)3 (0.4%)14 (1.2%)4 (0.7%)28 (4.7%)3 (0.8%)127 (0.9%)
Severe asphyxia*1 (0.3%)0 (0.0%)1 (0.2%)0 (0.0%)2 (0.2%)1 (0.0%)0 (0.0%)1 (0.1%)3 (0.7%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)9 (0.1%)
Erb’s palsy*0 (0.0%)0 (0.0%)1 (0.2%)0 (0.0%)2 (0.2%)3 (0.1%)1 (0.1%)0 (0.0%)0 (0.0%)0 (0.0%)1 (0.1%)0 (0.0%)3 (0.5%)1 (0.3%)12 (0.1%)

Distribution of categories of caesarean sections in labour in nulliparous women with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses (Group 1 according to the Robson’s Ten Group Classification System) in 14 maternity units in Slovenia in years 2013 and 2014.

CategoryMaternity unit
1234567891011121314over all
Total number of deliveries in3231366567514113836291421720418824116160852935413572
Group 1 in each maternity unit
Number of CS in Group 13214123611983971079074961098085741567
(% of CS in Group 1)*(9.9%)(10.3%)(4.1%)(11.9%)(17.4%)(10.9%)(7.5%)(12.5%)(17.7%)(11.7%)(9.4%)(13.2%)(14.4%)(20.9%)(12.0%)
Foetal distress + no oxytocin*635743030747168715167
(18.8%)(24.8%)(30.4%)(6.6%)(15.2%)(7.6%)(6.5%)(4.4%)(9.5%)(16.7%)(7.3%)(8.8%)(1.2%)(6.8%)(10.7%)
Poor response0204052171070231
(maximum dose reached)*(0.0%)(1.4%)(0.0%)(6.6%)(0.0%)(1.3%)(1.9%)(1.1%)(9.5%)(1.0%)(0.0%)(8.8%)(0.0%)(2.7%)(2.0%)
Inability to reach maximum04005151601103238
dose due to foetal intolerance*(0.0%)(2.8%)(0.0%)(0.0%)(2.5%)(3.8%)(0.9%)(6.7%)(0.0%)(1.0%)(0.9%)(0.0%)(3.5%)(2.7%)(2.4%)
Inability to reach maximum12126144611423235244103910369
dose because of over- contracting or not following units protocol*(37.5%)(8.5%)(26.1%)(23.0%)(23.2%)(28.7%)(21.5%)(25.6%)(6.8%)(25.0%)(37.6%)(0.0%)(45.9%)(13.5%)(23.5%)
Cephalopelvic disproportion*637528501211222122724232127415
(18.8%)(26.2%)(21.7%)(45.9%)(25.3%)(30.5%)(11.2%)(24.4%)(16.2%)(28.1%)(22.0%)(28.7%)(24.7%)(36.5%)(26.5%)
Malposition422232423310191369810156
(e.g. occipito posterior)*(12.5%)(15.6%)(8.7%)(4.9%)(12.1%)(5.8%)(2.8%)(11.1%)(25.7%)(13.5%)(5.5%)(11.3%)(9.4%)(13.5%)(10.0%)
Impossible to classify*4293843895924241429341318391
(12.5%)(20.6%)(13.0%)(13.1%)(21.7%)(22.4%)(55.1%)(26.7%)(32.4%)(14.6%)(26.6%)(42.5%)(15.3%)(24.3%)(25.0%)
eISSN:
1854-2476
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Hygiene and Environmental Medicine