Objectives. To study the trend of Caesarean section (CS) rate increase in the Tula region. Methods. A multicenter retrospective study of labor and delivery reports of women in Tula region, Russia who had CS procedures between the years 2000 and 2010. Robson’s Ten-Group Classification System (10-group classification) provides a clinically relevant classification of CS rates that provides a useful basis for internation-al comparisons and trend analyses. Results. In Tula region the total number of deliveries increased by 26.6% from the year 2000 as compared to 2010, the CS rate increased from 17.1 to 27.7%. The increase in CS deliveries was mostly attributed to three characteristic groups: multiparous women with uterine cicatrix; primaparous women who had medical conditions for a planned CS and these, who had labor induction; women with a gestational age less than 37 weeks. The largest Robson group was nulliparous women in spontaneous labor. Conclusions. Future efforts to reduce the overall CS rate should be focussed on reducing the primary CS rate.
Caesarean section, pregnancy, Robson classification, delivery, operation.
1. Anan´ev V.A., Pobedinskiy N.M., Chernukha E.A. Oslozhneniya i zabolevaemost´ posle kesareva secheniya v poslerodovom i otdalennom periode. Akusherstvo i ginekologiya. 2005. №2. S. 52-54.
2. Kulakov V.I., Chernukha E.A. Sovremennyy vzglyad na problemu kesareva secheniya. Materialy I regional´nogo nauchnogo foruma «Mat´ i ditya». Kazan´, 2007. S. 85-88.
3. Okhapkin M.B., Khitrov M.V., Gur´ev D.L. Rezul´taty raboty sluzhby rodovspomozheniya Yaro-slavlya v sootvetstvii s printsipami dokazatel´noy meditsiny. Akusherstvo i ginekologiya. 2012.№4. S. 94-97.
4. Pavlova T.Yu. Puti snizheniya chastoty povtornogo kesareva secheniya v respublike Sakha (Yaku-tiya): Dis. … kand.med.nauk. M., 2009. 133 s.
5. Rybin M.V. Struktura pokazaniy i prichiny rosta chastoty operatsii kesareva secheniya v ro-dil´nom dome pri mnogoprofil´noy bol´nitse №7 g.Moskvy. Materialy IV Assamblei «Zdorov´e sto-litsy». 2005. S. 1-2.
6. Kesarevo sechenie v sovremennom akusherstve / Savel´eva G.M., Karaganova E.Ya., Kurtser M.A. [i dr.]. Akusherstvo i ginekologiya. 2007. №2. S. 3-8.
7. Sukhanova L.P. Analiz pokazateley zdorov´ya materi i rebenka v usloviyakh reformirovaniya sluzhby rodovspomozheniya v Rossii v 2006-2011 gg. Doklad FGBOU TsNIIOIZ Minzdrava RF. 2012. 125 s.
8. Analysis of Cesarean Delivery at Assiut University Hospital Using Ten Group Classification System / Abdel-Aleem H., Shaaban O.M., Hassanin A.I. [et al.]. Int.J.Gynecol.Obstet. 2013. Vol. 123, №2. P. 119-123.
9. Althabe F., Belizan J. Caesarean Section: the Paradox (Comment) . Lancet. 2006. Vol. 368. №9546. P. 1472-1473.
10. WHO Global Survey on Maternal and Perinatal Health in Latin America: Classifying Caesarean Sec-tions / Betran A.P., Gumezoglu A.M., Robson M.S. [et al.]. Reprod. Health. 2009. Vol. 6. R. 18.
11. Comparative Analysis of Cesarean Delivery Rates over a 10-year Period in a Single Institution Using 10-class Classification / Cirello E., Locatelli A., Incerti M. [et al.]. J.Mater. Fetal Neonatal Med. 2012. Vol. 25, №12. R. 2717-2720.
12. Chaillet N., Dumont A. Evidence-Based Strategies for Reducing Cesarean Rates: a Meta-Analysis /. Birth. 2007. Vol. 34. №1. P. 53-64.
13. Chong C., Su L.L., Biswas A. Changing Trends of Cesarean Section Births by the Robson Ten Group Classification in a Tertiatry Teaching Hospital. Acta.Obstet.Gynecol. Scand. 2012. Vol. 91, №12. P. 1422-1427.
14. An analysis of the indications for cesarean section in a teaching hospital in China / Gao Y., Xue G., Chen G. [et al.]. Eur. J. Obstet. Gynecol. Reprod. Biol. 2013. Vol. 170. №2. P. 414-418.
15. Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities / Gon-zales G.F., Tapia V.L., Fort A.L. [et al.]. Int. J. Womens Health. 2013. P. 637-645.
16. Howell S., Johnston T., Macleod S.L. Trends and Determinants of Caesarean Sections Births in Queensland, 1977-2006. Aust.N.Z.Obstet.Gynaecol. 2009. Vol. 49, №6. P. 606-611.
17. Examing Caesarean Section Rates in Canada Using the Robson Classification System / Kelly S., Spraque A., Fell D.B. [et al.]. J.Obstet.Gynaecol.Can. 2013. Vol. 35, №3. P. 206-214.
18. Increasing Caesarean Section Rates among Low-risk Groups: a Panel Study Classifying Deliveries According to Robson at a University Hospital in Tanzania / Litorp H., Kidanto H.L., Nystrom L. [et al.]. BMC Pregnancy Childbirth. 2013. Vol. 13. P. 107.
19. McCarthy F.P., Rigg L., Cullinane F. A New Way of Looking at Caesarean Section Births. Aust. N.Z. Obstet. Gynaecol. 2007. Vol. 47. P. 316-320.
20. Menacker F., Hamilton B.E. Recent Trends in Cesarean Delivery in the United States . NCHS Data Brief. 2010. Vol. 35. P. 1-8.
21. Trends in Mode of Delivery during 1984-2003: Can They Be Explained By Pregnancy and Delivery Complications? / O´Leary C.M., Klerk N., Keogh J. [et al.]. Br.J.Obstet.Gynaecol. 2007. Vol. 114. P. 855-864.
22. Suzuki S., Nakata M. Factors associated with the recent increasing cesarean delivery rate at a Japa-nese perinatal center. ISRN Obstet. Gynecol. 2013.P. 863-877.
23. Why we do caesars: a comparison of the trends in caesarean section delivery over a decade / Wang C.P., Tan W.C., Kanagalingam D. [et al.]. Ann Acad Med Singapore. 2013. Vol. 42. №8. P. 408-412.
24. Robson M.S. Classification of Cesarean Sections . Fetal and Maternal Medicine Review. 2001. Vol. 12, №1. R. 23-39.
25. Methods of Achieving and Maintaining an Appropriate Caesarean Section Rate / Robson M.S., Har-tigan L., Murphy M.. Best Pract.Res.Clin.Obstet.Gynaecol. 2013. Vol. 27, №2. R. 297-308.
