Cesarean rates in a Chilean public hospital and the use of a new prioritization criteria: the relevance index

Masami Yamamoto*, Rodrigo Latorre, Juan Rojas, Bernardita Walker, Felipe Jordán, Jorge Carrillo, Enrique Paiva, Alvaro Insunza

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Aim: Cesarean section rates are increasing worldwide and Robson's classification system allows a practical approach to study this phenomenon. C-section in Chile has been indicated as unexpectedly high, with important variability within the country and payment systems. The aim was to report our data using Robson's system and the evolution of local C-section rate in a public hospital during a 9-year period. Methods: Retrospective analysis (2005–April 2014), in a metropolitan hospital in Santiago. All deliveries were classified into Robson groups. Time changes were analyzed with Pearson's correlation. P value <0.05 was considered significant. A ‘relevance index’ (RI) for each group was calculated as 100 × C-S rate × relative contribution. Results: The overall C-section rate increased from 24 to 27% (P < 0.05) in 53 571 deliveries, with a greater increase in groups 1 (nulliparous, single, term cephalic, spontaneous labor), 3 (multiparous, single, no previous C-S, term cephalic, spontaneous labor) and 4 (multiparous, single, no previous C-S, term cephalic, induced or no labor). Despite no increase in Group 5 (women with one or more previous C-S) this group had the highest RI (20.3), which defined priority for intervention over others. Conclusion: C-S rate was lower than that reported in other centers from Chile and Latin America. Robson's classification and the RI allowed prioritization. Although increase in groups 1, 3 and 4, group 5 needs attention because of stronger impact on overall C-S rate. This analysis allowed to define how to lower C-S rate in our institution.

Original languageEnglish
Pages (from-to)578-584
Number of pages7
JournalJournal of Obstetrics and Gynaecology Research
Volume45
Issue number3
DOIs
StatePublished - Mar 2019

Bibliographical note

Publisher Copyright:
© 2018 Japan Society of Obstetrics and Gynecology

Keywords

  • breech
  • cesarean section
  • CS indication
  • Robson classification

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