A Systematic Review: Impact of Caesarean Rate after Implementation of Robson’s Criteria at Secondary and Tertiary Hospital
When medically justified, a caesarean section can effectively prevent maternal and perinatal mortality and morbidity. However, there is no evidence showing the benefits of caesarean delivery for women or infants who do not require the procedure . In recent years, governments and clinicians have expressed concern about the rise in the numbers of caesarean section births and the potential negative consequences for maternal and infant health [1–4]. This study aims to provide a description of how Robson’s criteria give an implication of decreasing caesarean rate. This is a literature study, online databases such as ProQuest, JSTOR, EBSCO, Biomedicina were searched with time restriction from 2000 to 2016. The population of this study were taken
from five countries with different culture, demography, per capita income and public health policy such as Canada, Ireland, Singapore, Peru, Lithuania, and India. Of the five countries, only Canada has a decreasing caesarean rate Intervention groups of lowrisk pregnancy change 22.5% to 21.8% (CI 0,80 to 0,99 adjusted risk difference –1.8% (95% CI –3.8 to 0.2) but Intervention groups of high-risk pregnancy change 23.3% to
23.5% with p = 0.35; p 0.03 for interaction. Other countries still have an increasing caesarean rate. The implementation of Robson’s criteria should be customized with the ability in healthcare providers and also health policy in each country.
Keywords: impact, caesarean rate, Robson’s, hospital
 World Health Organization. (2015). WHO Statement on caesarean section rates. Human Reproduction Programme. Retrieved from http://www.who.int/ reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/
 Ozdemirci, S., et al. (2014). Reassessment of caesarean section rates between 2011 and 2014 with ROBSON classification system. 14th World Congress in Fetal Medicine.
 Born Provincial Rounds November. (2012). BORN Ontario Reporting using the Robson Cesarean Section Classification, pp. 1–30.
 Barčaite, E., Kemekliene, G., Railaite, D. R., et al. (2015). Cesarean section rates in Lithuania using Robson Ten Group Classification System. Medicine, vol. 51, no. 5, pp. 280–285.
 Roberts, C. L. and Nippita, T. A. (2015). International caesarean section rates: The rising tide. The Lancet Global Health, vol. 3, no. 5. pp. e241–e242.
 Romero, S. T., Coulson, C. C., and Galvin, S. L. (2012). Cesarean delivery on maternal request: A Western North Carolina perspective. Maternal and Child Health Journal, vol. 16, no. 3. pp. 725–734.
 Souza, J. P., 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, vol. 8, pp. 1–10.
 Costa, M. L., Cecatti, J. G., Souza, J. P., et al. (2010). Using a caesarean section classification system based on characteristics of the population as a way of monitoring obstetric practice. Reproductive Health, vol. 7, no. 1.
 Belizán, J. M., Althabe, F., and Cafferata, M. L. (2007). Health consequences of the increasing caesarean section rates. Epidemiology, vol. 18, no. 4. pp. 485–486.
 Dowson, S. and Lack, J. A. L. (1996). Classification of caesarean sections. Wiley Online Library.
 Betrán, A. P., Vindevoghel, N., Souza, J. P., et al. (2014). A systematic review of the Robson classification for caesarean section: What works, doesn’t work and how to improve it. PLoS One, vol. 9, no. 6.
 Chaillet, N., et al. (2015). A cluster-randomized trial to reduce cesarean delivery rates in Quebec. The New England Journal of Medicine, vol. 372, no. 18, pp. 1710– 1721.
 Lutomski, J. E., Murphy, M., Devane, D., et al. (2014). Private health care coverage and increased risk of obstetric intervention. BMC Pregnancy Childbirth, vol. 14, no. 1.
 Chong, C., Su, L. L., and Biswas, A. (2012). Changing trends of cesarean section births by the Robson Ten Group Classification in a tertiary teaching hospital. Acta Obstetricia et Gynecologica Scandinavica, vol. 91, no. 12, pp. 1422–1427.
 Tapia, V., Betran, A. P., and Gonzales, G. F. (2016). Caesarean section in Peru: Analysis of trends using the Robson classification system. PLoS One, vol. 11, no. 2.
 Unnikrishnan, B., et al. (2010). Trends and indications for caesarean section in a tertiary care obstetric hospital in Coastal South India. Australasian Medical Journal, vol. 12, no. 10, pp. 821–825.
 Cavallaro, F. L., Cresswell, J. A., and Ronsmans, C. (2016). Obstetricians’ opinions of the optimal caesarean rate: A global survey. PLoS One, vol. 11, no. 3, pp. 1–15.
 Visser, G. H. A. (2015). Women are designed to deliver vaginally and not by cesarean section: An obstetrician’s view. Neonatology, vol. 107, no. 1. pp. 8–13.