O&G Forum

OBSTETRICS & GYNAECOLOGY FORUM 2021 | ISSUE 3 | 16 Based on findings from this study, the caesarean section rate remains high with most caesarean sections performed on women with previous scars. Indications for primary caesarean deliveries need to also be explored further. The American college of Obstetricians and Gynaecologists as well as the Society for Maternal and Fetal medicine have outlined strategies to reduce primary CS. These include operative vaginal delivery in the second stage and not using prolonged latent phase as an indication for CS. In addition, before diagnosing arrest of labour in second stage of labour, and if maternal and fetal conditions permit, allow for following: at least 2 hours of pushing in multiparous women and at least 3 hours of pushing in nulliparous women. 26 The strength of our study is the sample size and that we looked at deliveries over several years. Limitations of the study include its retrospective nature, with some missing data. However, measures were put into place to exclude these missing data. Conclusion The average caesarean section rate was 55% with Robson’s group 5 and group 10 as the greatest contributors. Reducing primary caesarean sections and encouraging VBAC may be a solution to this high rate. In a tertiary hospital, Robson’s 10 group classification alone does not give a full description of the caesarean section rate; other causes like medical conditions need to be considered. Hypertensive disorders in pregnancy were the medical condition associated with the highest caesarean section rate and was also the largest contributor of CS to the near miss category. Contrary to other data, our data showed no statistically significant difference in the rate of PPH between the NVD and caesarean section groups. More studies should still be done on the Robson’s classification to help hospitals formulate strategies to reduce the caesarean section rate and reach the WHO recommendations. References 1. 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O&G Forum 2021; 31: 13 - 16 ORIGINAL RESEARCH