Background: The global increase in caesarean section (CS) rates has become a major public health concern. The Modified Robson Ten-Group Classification System (TGCS) offers a standardized method to analyze CS trends and identify contributing factors. Tertiary care hospitals, which frequently manage high-risk and referred pregnancies, often report elevated CS rates, emphasizing the need for periodic institutional audits.
Objective: To determine the caesarean section rate in a tertiary care hospital and identify major contributing factors using the Modified Robson classification.
Materials and Methods: This one-year observational cross-sectional study included 100 women delivering at ?28 weeks of gestation in the Department of Obstetrics and Gynaecology of a tertiary care hospital. All deliveries were classified into the Modified Robson Ten Groups based on parity, previous CS, gestational age, fetal presentation, plurality, and onset of labor. Data were collected from medical records and analyzed using SPSS version 25.
Results: The overall CS rate was 60%. Group 5 (previous CS, single cephalic, ?37 weeks) contributed the highest proportion (37.5%), followed by Group 2 (12%) and Group 6 (7.5%). The most frequent indications were previous LSCS (33.3%), fetal distress (20%), and non-progress of labor (13.3%). Maternal complications were more common after CS (10%) compared with vaginal births (5%), and NICU admissions were also higher in the CS group (16.7% vs. 7.5%).
Conclusion: The study demonstrates a significantly elevated CS rate predominantly driven by repeat CS, induction failures, and malpresentations. Strengthening VBAC counseling, optimizing induction practices, and adherence to evidence-based obstetric protocols are essential to reduce unnecessary caesarean deliveries and improve maternal and neonatal outcomes.
International Journal of Clinical Obstetrics and Gynaecology
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