Evaluation of caesarean rates according to Robson classification using a newly developed smart phone application in a tertiary centre in Sri Lanka: Comparative study

Abstract

Objective Caesarean section (CS) rates are increasing in Sri Lanka. More than half of births will occur through CS by 2025. CS should be medically indicated to reduce maternal morbidity. Robson classification is useful in assessing the indications for CS. It is difficult to obtain high-quality prospective data using traditional data collection methods. We intend to assess the use of new technology for this purpose. Methods We used the RobsApp® which is a newly developed smart phone application from April to October 2019 at the professorial unit De Soysa Hospital for Women (DSHW) for prospective data collection and analysis of 1712 deliveries according to Robson classification. This data is compared with Robson standards and previous traditional data collection methods. Results The quality of data gathered matched the recommendations by Robson guidance. The overall CS rate was 33.0%. The majority of the CS were carried out for Robson category 5a. Breech presentation accounted for 11.6% of CSs. Emergency CS contributed to 49.6% with CTG abnormalities being the most frequent indication. Conclusions RobsApp® is a convenient method for prospective data collection which allows achievement of the data quality recommended by the Robson guidance. The CS rates are rising in professorial unit DSHW. Increasingly CS are being performed for reasons other than for past sections.