A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It

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dc.contributor.authorBetran, Ana Pilar
dc.contributor.authorVindevoghel, Nadia
dc.contributor.authorSouza, Joao Paulo
dc.contributor.authorGuelmezoglu, A. Metin
dc.contributor.authorTorloni, Maria Regina [UNIFESP]
dc.contributor.institutionWHO
dc.contributor.institutionMaternal Child Clin
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionBrazilian Cochrane Ctr
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:37:25Z
dc.date.available2016-01-24T14:37:25Z
dc.date.issued2014-06-03
dc.description.abstractBackground: Caesarean sections (CS) rates continue to increase worldwide without a clear understanding of the main drivers and consequences. the lack of a standardized internationally-accepted classification system to monitor and compare CS rates is one of the barriers to a better understanding of this trend. the Robson's 10-group classification is based on simple obstetrical parameters (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) and does not involve the indication for CS. This classification has become very popular over the last years in many countries. We conducted a systematic review to synthesize the experience of users on the implementation of this classification and proposed adaptations.Methods: Four electronic databases were searched. A three-step thematic synthesis approach and a qualitative metasummary method were used.Results: 232 unique reports were identified, 97 were selected for full-text evaluation and 73 were included. These publications reported on the use of Robson's classification in over 33 million women from 31 countries. According to users, the main strengths of the classification are its simplicity, robustness, reliability and flexibility. However, missing data, misclassification of women and lack of definition or consensus on core variables of the classification are challenges. To improve the classification for local use and to decrease heterogeneity within groups, several subdivisions in each of the 10 groups have been proposed. Group 5 (women with previous CS) received the largest number of suggestions.Conclusions: the use of the Robson classification is increasing rapidly and spontaneously worldwide. Despite some limitations, this classification is easy to implement and interpret. Several suggested modifications could be useful to help facilities and countries as they work towards its implementation.en
dc.description.affiliationWHO, UNDP UNFPA UNICEF WHO World Bank Special Programm, Dept Reprod Hlth & Res, CH-1211 Geneva, Switzerland
dc.description.affiliationMaternal Child Clin, Calgary, AB, Canada
dc.description.affiliationUniv São Paulo, Ribeirao Preto Med Sch, Dept Social Med, Ribeirao Preto, SP, Brazil
dc.description.affiliationBrazilian Cochrane Ctr, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Internal Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at the Department of Reproductive Health and Research of the World Health Organization
dc.format.extent10
dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0097769
dc.identifier.citationPlos One. San Francisco: Public Library Science, v. 9, n. 6, 10 p., 2014.
dc.identifier.doi10.1371/journal.pone.0097769
dc.identifier.fileWOS000336911400021.pdf
dc.identifier.issn1932-6203
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37858
dc.identifier.wosWOS:000336911400021
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleA Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve Iten
dc.typeinfo:eu-repo/semantics/article
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