Cesarean Section Rate and Associated Risk Factors in Group 1 Robson Classification
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Abstract
Objectives: To evaluate cesarean section (CS) rate among women in group 1 Robson classification, pregnancy outcomes and associated factors.
Materials and Methods: A total of 800 women classified in group 1 Robson classification were included. Data were extracted from medical records including maternal demographic data, obstetric characteristics, labor characteristics and management (cervical dilatation on admission, types of membranes rupture, cervical dilatation at artificial membranes rupture, labor augmentation, and use of analgesia), route of delivery, indications for CS, and pregnancy outcomes.
Results: Overall CS rate was 24.7%. Majority had cervical dilation at admission of < 5 cm (86%). Amniotomy was performed in 66.4% and, of which, 36.3% were performed when cervical dilatation of < 5 cm. Cephalopelvic disproportion (CPD) was the most common indication (74.7 %) followed by and non-reassuring fetal heart rate status (21.2%). Univariate analysis showed that maternal overweight and obesity, cervical dilatation of < 5 cm at admission, spontaneous rupture of the membranes, amniotomy at cervical dilatation of < 5 cm, gestational diabetes mellitus, and preeclampsia were significantly associated with CS. Logistic regression analysis revealed that significant independent factors for CS included overweight or obesity (adjusted odds ratio (OR) 1.58, 95% confidence interval (CI) 1.04-2.10, p = 0.033), amniotomy at cervical dilatation of < 5 cm and spontaneous rupture of membranes (adjusted OR 2.62, 95%CI 1.65-4.17, p < 0.001 and adjusted OR 2.87, 95%CI 1.82-4.53, p < 0.001 respectively).
Conclusion: CS rate among women in group 1 Robson classification was 24.7%. Maternal overweight and obesity, spontaneous rupture of membranes, amniotomy at cervical dilatation of < 5 cm, and preeclampsia were independent associated factors for CS.
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