An evaluation of cesarean rate in turkey by the Robson ten group classification system: How to reduce cesarean rates?




Primary cesarean, Rising cesarean rates, Robson classification


Aim: Caesarean section (CS) rates, as is the case in the world, showed a significant increase in Turkey over the last decade. The World Health Organization has approved the Robson10-Group Classification System (TGCS) as a global standard to facilitate the analysis and comparison of CS rates. The present study aimed to analyze the TGCS to CS ratio in Turkey and determine CS reduction strategies. Methods: The data for this retrospective cohort study were collected from the records of women who gave birth between January 1, 2011 and December 31, 2014 in a tertiary center. All data were obtained from the hospital database and patient files. The patients were grouped using TGCS. The contribution of each group to CS ratios was determined. Results: Between 2011 and 2014, a total of 25,653 out of 63,476 deliveries were performed by CS. It was determined that the CS rate was 36% in 2011 and increased to 44% in 2014 (P<0.001). According to TGCS, the biggest contribution to this increase belonged to the Class 5 group. This group included 40.7% (2073/5096) of all patients undergoing cesarean section in 2011, 37.3% (2045/5480) in 2012, 27.1% (1859/6857) in 2013, and 36.8% (3025/8220) in 2014. While the rates of patients in Class 1,3 and 10 increased significantly over the years in which the study data were evaluated, rates in Class 2 and 4 decreased (P<0.001). Conclusion: According to TGCS, strategies to prevent the increase in CS ratios should be developed to reduce Class 1, 3 and 5 patients. In this context, strategies to reduce CS ratios can be established through obstetric practices and the health policies of countries.


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Research Article

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Başer E, Aydoğan Kırmızı D, Özdemirci Şafak, Kasapoğlu T, Demirdağ E, Tapısız Ömer L, Yalvaç ES, Moraloğlu Tekin Özlem. An evaluation of cesarean rate in turkey by the Robson ten group classification system: How to reduce cesarean rates?. J Surg Med [Internet]. 2020 Nov. 1 [cited 2022 Jun. 25];4(11):1031-5. Available from: