Rationalizing the use of caesarean section in Egypt through implementing 10 group Classification system

- What are the variables of Robson Classification?

Parity, previous CS, onset of labor, gestational age, number of fetuses, lie and presentation of the fetus. are the variables for Robson classification that can be assessed as shown in table 1

Table 1 variant for Robson Classification

parity

· Nullipara ( no deliveries before )

· Multipara ( one or more deliveries irrespective of the mode of delivery and the outcome of delivery )

Previous CS

· Yes

· No ( no previous CS even if there are multiple vaginal deliveries before )

Onset of labour

· Spontaneous ( women who entered labour spontaneously even if she received oxytocin or had an amniotomy performed for augmentation (acceleration) of labour after that .

· Induced (woman was not in labour and was then induced by any method of induction is valid including amniotomy, misoprostol, oxytocin, intracervical Foley balloon, laminariaor other. )

· Prelabour CS ( planned elective CS before the onset of labour )

Number of Fetuses

· Singleton ( even if dead more than 22 weeks of gestation )

· Multiple ( irrespective to living condition as long as they are more than 22 weeks )

Gestational

Age

· Preterm (less than 37 weeks)

· Full term (37 weeks or more)

Fetal lie and Presentation

· Cephalic presentation

· Breech presentation

· Transverse lie

According to these variables, 10 groups classification system was created known as Robson classification as shown in table 2 and figure 1

Table 2 -10 groups Robson classification

Group

Nulliparous with single cephalic pregnancy, ≥37 weeks gestation in

spontaneous labour

Group

Nulliparous with single cephalic pregnancy, ≥ 37 weeks gestation who either

had labour induced or were delivered by CS before labour

Group

Multiparous without a previous uterine scar, with single cephalic pregnancy,

≥37 weeks gestation in spontaneous labour

Group 4

Multiparous without a previous uterine scar, with single cephalic pregnancy,

≥37 weeks gestation who either had labour induced or were delivered by CS

before labour

Group

All multiparous with at least one previous uterine scar, with single cephalic

pregnancy, ≥37 weeks gestation

Group

All nulliparous women with a single breech pregnancy

Group

All multiparous women with a single breech pregnancy including women

with previous uterine scars

Group

All women with multiple pregnancies including women with previous

uterine scars

Group

All women with a single pregnancy with a transverse or oblique lie, including

women with previous uterine scars

Group

All women with a single cephalic pregnancy < 37 weeks gestation, including

women with previous scars

Fig 1 Robson groups