USING THE ROBSON CLASSIFICATION TO ESTIMATE THE CAESAREAN SECTION RATE AND LOOK FOR WAYS TO REDUCE IT

Abstract

Objective. To assess the rate of Caesarean Section (CS) using the Robson method in the work of obstetric hospitals to find ways to reduce it. Materials and methods of the study. A retrospective study was conducted at the clinical sites of the Department of Obstetrics and Gynecology No. 2 of the NAO "Astana Medical University", Astana, and the Department of Obstetrics and Gynecology of the Pavlodar branch of the NAO "Semey Medical University", Pavlodar. For the 4th quarter of 2023, 3087 birth histories of the City Hospital No. 1 of Astana (MO A) and 1022 birth histories of the POPC No. 1 (MO B) were analyzed. The data were pre-processed in MS Excel 2017. Student's T-test was used for statistical analysis. Results. The number of births in MO A and B is 3087 and 1022. The share of CS among births in MO A is 23.94%, and in MO B - 22.31%. The total number of births is 4109. The study revealed that in MO A the following groups and subgroups made the greatest contribution to the overall frequency of CS: 5a - 158 (21.21%); 5b - 130 (17.45%); 10 - 78 (10.46%); 4b - 76 (10.20%), as well as 2a and 2b - 68 and 63 mothers, respectively (9.13% and 8.46%). In terms of the frequency of abdominal deliveries in MO B, the greatest contribution to the overall frequency of CS was made by the following groups and subgroups: 5b (27.19%); 5a (15.79%); 2a (7.89%); 6 and 10 (7.46% each). Conclusions. Relatively low rates of CS were noted in the obstetric block of the City Hospital No. 1 of Astana in groups 3, 6 and 7, which indicates good skills of the staff in managing labor in pure breech presentation. For institution B, these groups are a reserve for reducing the frequency of CS by performing external obstetric version and training in the skills of managing labor in pure breech presentation. Relatively high rate of CS in the obstetric block of the City Hospital No. 1 of Astana in groups 4b - 10.20% (2.19%) and 5 - 21.21% (15.79%) is a reserve for reducing abdominal delivery by conducting an audit of the effectiveness of labor induction. In group 5, it is necessary to revise the policy of the medical organization in favor of vaginal delivery.