Audit of Caesarean Section using the Modified Robson’s Criteria at a Cottage Hospital in Port-Harcourt, Nigeria

Abstract

Introduction: There has been growing concerns about the rising trend in caesarean section (CS) rate worldwide. A  clinical audit of CS using Robson group classification has been recommended as a tool to reverse this rising trend. This  study was carried out to re-audit CS at a Cottage Hospital in Port-Harcourt, South-south Nigeria. Methods: This was a retrospective analysis of cases of caesarean section carried out at the facility between 1st January 31st December, 2023 using the Robson Group classification and compared the findings with reports from the previous  review in the facility. 

Results: The CS rate was 29.1%. Majority (30.2%) of the women were in Robson Group 3 with Robson Group 6 being  the least (0.8%). The overall CS rate decreased from 32.4% in 2018 to 29.1% in 2023 though not statistically  significant, p>0.05. Women in Robson Group 5B were the highest contributors to the caesarean rate accounting for  28.4% while Robson Group 6A women were the least contributor to the CS rate with 0.2%. Previous caesarean section  was the commonest indication for CS among the women accounting for 36.8% unlike in the previous review where  dystocia was the commonest indication. 

Conclusions: Though there was a reduction in the overall CS rate, the 29.1% rate in this study is still higher than WHO  recommended rate. The implemented interventions needed to further reduce the CS rate should be sustained with  adequate monitoring of labour and strict adherence to criteria for selection of parturient for induction of labour and trial  of labour after previous caesarean section.