N 6 (178) 2021. P. 21–27

ON PATIENT SAFETY: IMPLEMENTATION OF THE M. ROBSON CLASSIFICATION AS A POSSIBILITY TO CONTROL THE FREQUENCY OF CESAREAN SECTION

G. S. Manasova, I. V. Spak, О. V. Zhovtenko

Odesa National Medical University MH of Ukraine, Odesa, Ukraine

 DOI 10.54229/2226-2008-2021-6-4

Purpose. Delivery by caesarean section (CS) is now becoming an “epidemic” — in some countries it reaches 50% or more; often the operation is carried out at the request or the slightest doubt of the woman. An increase in CS frequency is not always accompanied by a predicted improvement in perinatal mortality.

Objective: To develop a strategy for women to gain a positive pregnancy experience based on the analysis of the frequency of caesarean section in the database of a linear maternity hospital using the Robson classification.

Materials and methods. Retrospective analysis of childbirth histories of an urban maternity hospital with a specialization in preterm birth management in 2015–2019.

Research results. When analyzing 10,345 births, it was found that 3598 or 34.78% of women were delivered by CS surgery. The frequency of CS in group 1 averages (15.71±2.34)% (12.93–20.03)%. Most often, primary CS is performed in the 2nd (84.45±1.62)%, 4th (68.97±4.93)% and 6th (97.08±1.7)% groups, and these groups are subsequently the largest in terms of repeated CS. Traditionally, a high frequency of CS is noted in the 7th (96.69±2.05)%, 8th (86.66±7.02)% and 10 groups (40.02±5.14)%. The most common indications for primary CS were fetal distress, breech presentation, multiple pregnancies, obstructive labor, and extragenital indications. It is necessary to note the socio-ethical indications as an urgent requirement of the patient.

Conclusions. The use of Robson’s classification made it possible to determine the main directions for improving the organization of medical care for women in labor in order to ensure safe childbirth: the development of uniform standards and their active implementation in the group of pregnant women in need of pre-induction and induction of labor, training and active use of simulation methods of training medical personnel in the management of childbirth. in breech presentation and multiple pregnancies, prevention of premature birth, psychoprophylactic work with women and family members.

Key words: cesarean section, Robson’s classification.

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