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    Classificação de Robson como instrumento de avaliação das taxas de cesáreas em um hospital público terciário da Amazônia ocidental brasileira
    (Universidade Federal de São Paulo (UNIFESP), 2021) Lima, Sheley Borges Gadelha De [UNIFESP]; Gabrielloni, Maria Cristina [UNIFESP]; Universidade Federal de São Paulo
    Objectives: Analyzing rates cesarean section according to Robson’s Classification System in a Brazilian Western Amazon town. Method: Prospective, exploratory transversal design study, carried out in a high risk reference maternity that exclusively serves the Unified Health System users, in Rio Branco, Acre State Capital and the neighboring towns. 1,581 childbirth admitted women in a six-month period were included. Data collection has gone through three stages. The first stage was made with all childbirth admitted women, by filling in Robson’s classification questionnaire and with Robson’s calculator App for Smartphone available. The second stage was carried out by filling in sociodemographic data available in the live birth declaration and vaginal birth record book. And the third stage was a structured interview aimed at the puerperal women who were submitted to cesarean section (CS) and complemented with prenatal card data, from maternal and newborn medical records. Descriptive and inferential analyses were performed using the Chi-square test to test the association between the variables. Results: 1,581 births out of 703 (44.5%) were CS, from these 37.3% were primiparous and 62.7% multiparous. Most of them were between 20 and 34 years old and were 12 years of study, on average. Most CS were performed in the labor absence in women with a gestational age of 39 weeks (61.1%). Regarding the distribution of Robson's groups, the largest group was G3 followed by G5, which had 75.0% of CS. This was the group that contributed most to the surgical births overall rate (30.7%). High rate of CS was also found in G2 67.1%, groups G6, G7, G8 had CS rates above 70%, with G9 having 100%. G10 had a 43.9% rate. The main CS medical indication was hypertensive disorder with 19.2%, followed by the previous cesarean section, 15.3%. The CS primary cause in Group 5 was the presence of an anterior CS (38%). Conclusion: Robson's Classification is a useful tool in CS rates monitoring and it is possible to identify the most affected population. The group that performed CS most was group 5, followed by groups 2 and 1. The indication for CS that most appeared was hypertensive disorder, followed by previous CS. The hypertensive disorder was not among the recommendations for CS programmed according to the CONITEC/MS guidelines. This finding becomes important to seek measures that aim to reduce the first CS in women without indication, reducing the chance of an CS in the next pregnancy and fetal, maternal complications.