OPTIMIZATION OF THE FREQUENCY AND STRUCTURE OF CESAREAN SECTIONS BASED ON ROBSON’S QUALIFICATION SYSTEM

Abstract

The aim: Analyze the frequency and structure of indications for cesarean section in municipal non-profit enterprise “Uzhgorod city maternity hospital” of Uzhgorod city council to determine promising ways to optimize the tactics of childbirth. Materials and methods: A comparative clinical and statistical analysis of the frequency and indications for caesarean section for 2011-2015 (first group) and 2016-2020 (second group) years according to the Robson system classification was conducted. Results: The increase in caesarean section had no effect on overall perinatal mortality. The main reserve for reducing the incidence of cesarean section is the primi- and se¬cundipara women with full-term singleton pregnancy, the cephalic presentation of the fetus. Increasing the proportion of vaginal births in women with a scar on the uterus is possible through careful selection of patients for vaginal birth. The high frequency of cesarean section in groups of women with premature births, multiple pregnancies, pelvic preterm births or abnormal preterm births is justified by modern obstetric approaches and does not significantly affect the overall frequency of cesarean section due to the small number of these groups. Conclusions: The reserve for reducing the frequency of cesarean sections is the standardization of medical care in obstetrics and also in social and legal protection of an obstetrician and gynecologist.