Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.11889/5872
Title: Caesarean section in Palestine using the Robson Ten Group Classification System: a population-based birth cohort study
Authors: Zimmo, Mohammed
Laine, Katariina
Hassan, Sahar
Bottcher, Bettina
Fosse, Erik
Al-Masri, Hadil
Zimmo, Khaled
Sørum Falk, Ragnhild
Lieng, Marit
Vikanes, Ase
Keywords: Caesarean section - Palestine
Perinatal Care - Palestine
Robson
Cohort analysis
Population
Issue Date: 20-Sep-2018
Publisher: BMJ Open
Abstract: Objective To analyse the current situation of caesarean section in Palestine using the Robson Ten Group Classification System (TGCS). Design A population-based birth cohort study. Setting Obstetrical departments in three governmental hospitals in Gaza. Participants All women (18 908) who gave birth between1 January 2016 and 30 April 2017. Methods The contributions of each group to the study population and to the overall rate of caesarean section were calculated, as well as the rate of caesarean section in each TGCS group. Differences in proportions between study hospitals were assessed by χ2 test. Main outcome measures The main outcome was the contributions of each group to the overall caesarean section rate. Results The overall rate of caesarean section was 22.9% (4337 of 18 908), ranging from 20.6% in hospital 1 to 24.6% in hospital 3. The largest contributors to the overall caesarean section rate were multiparous women with single cephalic fullterm pregnancy who had undergone at least one caesarean section (group 5, 42.6%), women with multiple pregnancies (group 8, 11.6%) and those with single cephalic preterm labour (group 10, 8.1%). Statistically significant differences in caesarean section rates between the study hospitals were observed in group 1 (nulliparous women with single cephalic full-term pregnancy and spontaneous labour), group 4 (multiparous with single cephalic full-term pregnancy with induced labour or prelabour caesarean section), group 5 (multiparous with single cephalic full-term pregnancy with previous caesarean section) and in group 7 (multiparous with breech presentation). Conclusion Women in groups 5, 8 and 10 were the largest contributors to the overall caesarean section rate in the study hospitals. Efforts to reduce the differences in obstetrical care between hospitals need to be directed towards increasing the proportion of vaginal births after caesarean section and by reducing primary caesarean section in multiple pregnancies and preterm labour
URI: https://bmjopen.bmj.com/content/8/10/e022875
http://hdl.handle.net/20.500.11889/5872
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