Obstetric audit of cesarean sections according to M. Robson classification criteria – the experience of St. Petersburg in 2020-2021
- Authors: Bezhenar V.F.1, Nesterov N.1, Pryalukhin I.A.2
-
Affiliations:
- Academician I.P. Pavlov First St. Petersburg State Medical University
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov
- Issue: Vol 71, No 2 (2022)
- Pages: 7-16
- Section: Public Health Organization
- URL: https://journals.eco-vector.com/jowd/article/view/101633
- DOI: https://doi.org/10.17816/JOWD101633
- ID: 101633
Cite item
Abstract
An external audit of the childbirth outcomes was conducted in accordance with M. Robson’s 10-group classification. The main determinants of indications and the frequency of cesarean section in obstetric medical organizations of St. Petersburg in 2020-2021 were analyzed in order to find effective mechanisms for reducing the frequency of сesarean delivery within the framework of compliance with modern principles of perinatal-oriented obstetrics and the preservation of a woman’s reproductive health. Possible effective reserves for reducing the frequency of CS are presented: personalized pre-gravidar preparation in high-perinatal risk women groups, personalized approach to methods of pre-induction and induction of labor in high-risk groups’ patients, rational management of labor in compliance with modern clinical recommendations, wider use of current classical external manual methods for antenatal correction of fetus pelvic presentation, prevention the primary cesarean deliveries, increase in the rate of vaginal deliveries among women with previous cesarean deliveries, optimization of effective antenatal psychological consultation about the delivery methods among pregnant women with breech presentation, previous cesarean deliveries and multiple pregnancy.
Full Text
About the authors
Vitaly F. Bezhenar
Academician I.P. Pavlov First St. Petersburg State Medical University
Email: bez-vitaliy@yandex.ru
ORCID iD: 0000-0002-7807-4929
SPIN-code: 8626-7555
Scopus Author ID: 57191963583
ResearcherId: R-7055-2017
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgNesterov Nesterov
Academician I.P. Pavlov First St. Petersburg State Medical University
Author for correspondence.
Email: ignester@yandex.ru
ORCID iD: 0000-0002-7558-7657
MD, Cand. Sci. (Med.), Assistant Professor
Russian Federation, Saint PetersburgIvan A. Pryalukhin
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov
Email: i_prialukhin@oparina4.ru
ORCID iD: 0000-0001-8867-3020
MD, Cand. Sci. (Med.)
Russian Federation, MoscowReferences
- Decree of Prezident of Russian Federation No. 1351 of 2007 Oct. 9 “Ob utverzhdenii Kontseptsii demograficheskoy politiki Rossiyskoy Federatsii na period do 2025 goda” (s izmeneniyami i dopolneniyami). Suppl. Kontseptsiya demograficheskoy politiki RF na period do 2025 g. (In Russ.). [cited 2021 Jan 28]. Available from: https://base.garant.ru/191961/
- Bacci A, Lewis G, Baltag V, Betrán AP. The introduction of confidential enquiries into maternal deaths and near-miss case reviews in the WHO European Region. Reprod Health Matters. 2007;15(30):145–152. doi: 10.1016/S0968-8080(07)30334-0
- The global strategy for women’s, children’s and Adolescents’ health (2016–2030). [cited 2021 Jan 28]. Available from: https://globalstrategy.everywomaneverychild.org/pdf/EWEC_globalstrategyreport_200915_FINAL_WEB.pdf
- Bezhenar VF, Adamyan LV, Filippov OS, et al. Maternal mortality in the North-Western federal region of the Russian Federation: a comparative analysis of 2018–2019, conceptual approaches to reduction. Problems of reproduction. 2020;26(6):32–40. (In Russ.). doi: 10.17116/repro20202606233
- Metodicheskoe pis’mo MZ RF ot 19.02.2019 No. 15-4/4/2-1286 “O vnedrenii klassifikatsii operatsii Kesareva secheniya M. Robsona”. (In Russ.). [cited 2021 Jan 28]. Available from: https://medvestnik.ru/content/documents/15-4-I-2-1286-ot-19-02-2019-g.html
- World Health Organization. [Internet]. WHO statement on caesarean section rates. Geneva: World Health Organization; 2015. [cited 2021 Jan 28]. Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1
- FIGO Working Group On Challenges In Care Of Mothers And Infants During Labour And Delivery. Best practice advice on the 10-Group Classification System for cesarean deliveries. Int J Gynaecol Obstet. 2016;135(2):232–233. doi: 10.1016/j.ijgo.2016.08.001
- Robson M. Classification of caesarean sections. Fetal Matern Med Rev. 2001;(12):23–39. doi: 10.1017/S0965539501000122
- Robson classification: Implementation manual. Geneva: World Health Organization; 2017. [cited 2021 Jan 28]. Available from: http://apps.who.int/iris/bitstream/handle/10665/259512/9789241513197-eng.pdf?sequence=1
- Rekomendatsii po vnedreniyu, ispol’zovaniyu i analizu otcheta po klassifikatsii operatsii kesarevo sechenie Robsona: metodicheskoe pis’mo. Moscow; 2019. (In Russ). [cited 2021 Jan 28]. Available from: https://tamponada.ru/assets/files/%D0%A0%D0%B5%D0%BA%D0%BE%D0%BC%D0%B5%D0%BD%D0%B4%D0%B0%D1%86%D0%B8%D0%B8%20%D0%9A%D0%A1%20%D0%A0%D0%BE%D0%B1%D1%81%D0%BE%D0%BD.pdf
- Vogel JP, Betrán AP, Vindevoghel N, et al. Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Glob Health. 2015;3(5):e260–e270. doi: 10.1016/S2214-109X(15)70094-X
- Tanaka K, Mahomed K. The ten-group Robson classification: A single centre approach identifying strategies to optimise caesarean section rates. Obstet Gynecol Int. 2017;2017:5648938. doi: 10.1155/2017/5648938
- Poryadok okazaniya meditsinskoy pomoshchi po profilyu “akusherstvo i ginekologiya” (Prikaz MZ RF ot 20.10.20 g. No. 1130n). (In Russ.). [cited 2021 Jan 28]. Available from: https://docs.cntd.ru/document/566162019
- Rody odnoplodnye, rodorazreshenie putem kesareva secheniya. Klinicheskie rekomendatsii Minzdrava RF. 2021. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/639_1
- Neudachnaya popytka stimulyatsii rodov (podgotovka sheyki matki k rodam i rodovozbuzhdenie). Klinicheskie rekomendatsii Minzdrava RF. 2021. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/640_1
- Rody odnoplodnye, samoproizvol’noe rodorazreshenie v zatylochnom predlezhanii (normal’nye rody). Klinicheskie rekomendatsii Minzdrava RF. 2021. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/636_1
- Prezhdevremennye rody. Klinicheskie rekomendatsii Minzdrava RF. 2020. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/331_1
- Preeklampsiya. Eklampsiya. Oteki, proteinuriya i gipertenzivnye rasstroystva vo vremya beremennosti, v rodakh i poslerodovom periode. Klinicheskie rekomendatsii Minzdrava RF. 2021. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/637_1
- Tazovoe predlezhanie ploda. Klinicheskie rekomendatsii Minzdrava RF. 2020. [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/626_1
- Mnogoplodnaya beremennost’. Klinicheskie rekomendatsii Minzdrava RF. 2021. (In Russ.). [cited 2021 Jan 28]. Available from: https://cr.minzdrav.gov.ru/recomend/638_1
- Kesarevo sechenie. Problemy abdominal’nogo akusherstva: ruk. dlya vrachei. Editor V.I. Krasnopol’skiy. 3th ed. Moscow; 2018. (In Russ.)
- Torloni MR, Betran AP, Souza JP, et al. Classifications for cesarean section: a systematic review. PLoS One. 2011;6(1):e14566. doi: 10.1371/journal.pone.0014566
- Betrán AP, Vindevoghel N, Souza JP, et al. A systematic review of the Robson classification for caesarean section: what works, doesn’t work and how to improve it. PLoS One. 2014;9(6):e97769. doi: 10.1371/journal.pone.0097769
- Souter VL, Katon JG, Chien A, et al. The Robson classification monitoring and comparing cesarean delivery rates. Obstet Gynecol. 2016;127(Suppl):131S. doi: 10.1097/01.A0G.0000483531.18218.6d
- Rijken MJ, Asah-Opoku K. Interpretation of caesarean section classifications. BJOG. 2019;126(6):701. doi: 10.1111/1471-0528.15627