Analysis of caesarean section rates according to Robson’s ten group classification system (RTGCS) at Bolan Medical Complex hospital, Quetta

  • Safia Bibi Associate Professor, OBG Unit 2, BMCH, Quetta
  • Rozina Khan Assistant Professor, OBG Unit 2, BMCH, Quetta
  • Saleem Javed Assistant Professor, Surgical Department, BMCH, Quetta
  • Momi Gul Assistant Professor, OBG Unit 2, BMCH, Quetta
  • Grannaz Mengal Senior LMO, OBG Unit 2, BMCH, Quetta
  • Fozia Muhammad Bakhsh Assistant Professor, OBG Unit 2, BMCH, Quetta
Keywords: Cesarean section, Robson’s ten group classification system


Objectives: To analyze the Cesarean Section (CS) rate at Unit II, Bolan Medical Complex Hospital, Quetta, using the Robson Ten Group Classification System.

Methodology: The present cross-sectional observational study was carried out within the Department of Obstetrics and Gynecology, specifically Unit II, at Bolan Medical Complex Hospital, located in Quetta, spanning from April 1, 2021, to March 31, 2022. All female individuals who underwent delivery procedures within this specified timeframe were enrolled as participants. Data pertaining to various variables were meticulously collected utilizing the Robson's App, with subsequent extraction from the Robson's classification report table for comprehensive analysis. The overall CS rates, relative size of each group, contribution of each group to the overall CS rate, and CS rates within each group were calculated.

Results: A total of 7,570 women presented for labor and delivery during the one-year study period. Five patients were unclassified, and 46 patients were excluded due to uterine rupture, leaving 7,519 deliveries for analysis. The CS rate was found to be 15.99%. The major contributors to the overall CS rate were Group 5 (54.66%), Groups 3 (9.65%) and 1 (9.57%) combined comprised around 74% of all cases of CS. Group 5 had an 80.7% CS rate, while 65.14% of the women in subgroup 5.1 (prior CS) had repeat CS. A total of 335 intrauterine deaths occurred during the study period, with 92% (308) being antepartum deaths and 8% (27) being intrapartum deaths.

Conclusion: The Robson's Ten Group Classification System serves as a standard method for analyzing obstetric practice and auditing CS rates. Encouragement of labor trials after one cesarean section is necessary, as the majority of women in Group 5.1 underwent repeat CS.

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