Classification of caesarean section in labour_
| Foetal distress (no oxytocin) | ||
|---|---|---|
| Dystocia | Inefficient uterine action (cervical dilatation <1 cm/h) | Poor response (maximum dose reached) * |
| Inability to reach maximum dose due to foetal intolerance | ||
| Inability to reach maximum dose because of over-contracting or not following unit protocol | ||
| Efficient uterine action (cervical dilatation >1cm/h) | Cephalopelvic disproportion | |
| Malposition (e.g. occipito posterior) | ||
Maternal and neonatal outcomes (corrected for lethal congenital malformations) in Group 1 (Robson’s Ten Group Classification System – nulliparous women with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses) in 14 maternity units in Slovenia in years 2013 and 2014_
| Outcome | Maternity unit | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | over all | |
| 3rd or 4th degree | 1 (0.3%) | 3 (0.2%) | 10 (1.8%) | 1 (0.2%) | 5 (0.4%) | 3.9 (1.1%) | 11 (0.8%) | 3 (0.4%) | 1 (0.2%) | 6 (0.7%) | 4 (0.3%) | 1 (0.2%) | 2 (0.3%) | 3 (0.8%) | 90 (0.7%) |
| perineal tear* | |||||||||||||||
| PPH >500ml* | 9 (2.8%) | 6 (0.4%) | 41 (7.2%) | 3 (0.6%) | 4 (0.4%) | 227 (6.2%) | 9 (0.6%) | 3 (0.4%) | 4 (1.0%) | 20 (2.4%) | 42 (3.6% | 8 (1.3%) | 36 (6.1%) | 3 (0.8%) | 415 (3.0%) |
| Transfusion* | 2 (0.6%) | 0 (0.0%) | 2 (0.4%) | 0 (0.0%) | 0 (0.0%) | 18 (0.5%) | 1 (0.1%) | 1 (0.1%) | 0 (0.0%) | 1 (0.1%) | 0 (0.0%) | 3 (0.5%) | 0 (0.0%) | 0 (0.0%) | 28 (0.2%) |
| Neonatal mortality | 0 (0.0%) | 0 (0.0%) | 1 (0.2%) | 0 (0.0%) | 0 (0.0%) | 1 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1 (0.3%) | 3 (0.0%) |
| Apgar <7 at 5’* | 1 (0.3%) | 0 (0.0%) | 1 (0.2%) | 1 (0.2%) | 6 (0.5%) | 19 (0.5%) | 8 (0.6%) | 1 (0.1%) | 5 (1.2%) | 2 (0.2%) | 2 (0.2%) | 1 (0.2%) | 2 (0.3%) | 3 (0.8%) | 52 (0.4%) |
| Perinatal asphyxia* | 8 (2.4%) | 5 (0.4%) | 1 (0.2%) | 0 (0.0%) | 16 (1.4%) | 30 (0.8%) | 1 (0.1%) | 2 (0.3%) | 12 (2.9%) | 3 (0.4%) | 14 (1.2%) | 4 (0.7%) | 28 (4.7%) | 3 (0.8%) | 127 (0.9%) |
| Severe asphyxia* | 1 (0.3%) | 0 (0.0%) | 1 (0.2%) | 0 (0.0%) | 2 (0.2%) | 1 (0.0%) | 0 (0.0%) | 1 (0.1%) | 3 (0.7%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 9 (0.1%) |
| Erb’s palsy* | 0 (0.0%) | 0 (0.0%) | 1 (0.2%) | 0 (0.0%) | 2 (0.2%) | 3 (0.1%) | 1 (0.1%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1 (0.1%) | 0 (0.0%) | 3 (0.5%) | 1 (0.3%) | 12 (0.1%) |
Distribution of categories of caesarean sections in labour in nulliparous women with spontaneous onset of labour at ≥37 weeks with single cephalic foetuses (Group 1 according to the Robson’s Ten Group Classification System) in 14 maternity units in Slovenia in years 2013 and 2014_
| Category | Maternity unit | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | over all | |
| Total number of deliveries in | 323 | 1366 | 567 | 514 | 1138 | 3629 | 1421 | 720 | 418 | 824 | 1161 | 608 | 529 | 354 | 13572 |
| Group 1 in each maternity unit | |||||||||||||||
| Number of CS in Group 1 | 32 | 141 | 23 | 61 | 198 | 397 | 107 | 90 | 74 | 96 | 109 | 80 | 85 | 74 | 1567 |
| (% of CS in Group 1)* | (9.9%) | (10.3%) | (4.1%) | (11.9%) | (17.4%) | (10.9%) | (7.5%) | (12.5%) | (17.7%) | (11.7%) | (9.4%) | (13.2%) | (14.4%) | (20.9%) | (12.0%) |
| Foetal distress + no oxytocin* | 6 | 35 | 7 | 4 | 30 | 30 | 7 | 4 | 7 | 16 | 8 | 7 | 1 | 5 | 167 |
| (18.8%) | (24.8%) | (30.4%) | (6.6%) | (15.2%) | (7.6%) | (6.5%) | (4.4%) | (9.5%) | (16.7%) | (7.3%) | (8.8%) | (1.2%) | (6.8%) | (10.7%) | |
| Poor response | 0 | 2 | 0 | 4 | 0 | 5 | 2 | 1 | 7 | 1 | 0 | 7 | 0 | 2 | 31 |
| (maximum dose reached)* | (0.0%) | (1.4%) | (0.0%) | (6.6%) | (0.0%) | (1.3%) | (1.9%) | (1.1%) | (9.5%) | (1.0%) | (0.0%) | (8.8%) | (0.0%) | (2.7%) | (2.0%) |
| Inability to reach maximum | 0 | 4 | 0 | 0 | 5 | 15 | 1 | 6 | 0 | 1 | 1 | 0 | 3 | 2 | 38 |
| dose due to foetal intolerance* | (0.0%) | (2.8%) | (0.0%) | (0.0%) | (2.5%) | (3.8%) | (0.9%) | (6.7%) | (0.0%) | (1.0%) | (0.9%) | (0.0%) | (3.5%) | (2.7%) | (2.4%) |
| Inability to reach maximum | 12 | 12 | 6 | 14 | 46 | 114 | 23 | 23 | 5 | 24 | 41 | 0 | 39 | 10 | 369 |
| dose because of over- contracting or not following units protocol* | (37.5%) | (8.5%) | (26.1%) | (23.0%) | (23.2%) | (28.7%) | (21.5%) | (25.6%) | (6.8%) | (25.0%) | (37.6%) | (0.0%) | (45.9%) | (13.5%) | (23.5%) |
| Cephalopelvic disproportion* | 6 | 37 | 5 | 28 | 50 | 121 | 12 | 22 | 12 | 27 | 24 | 23 | 21 | 27 | 415 |
| (18.8%) | (26.2%) | (21.7%) | (45.9%) | (25.3%) | (30.5%) | (11.2%) | (24.4%) | (16.2%) | (28.1%) | (22.0%) | (28.7%) | (24.7%) | (36.5%) | (26.5%) | |
| Malposition | 4 | 22 | 2 | 3 | 24 | 23 | 3 | 10 | 19 | 13 | 6 | 9 | 8 | 10 | 156 |
| (e.g. occipito posterior)* | (12.5%) | (15.6%) | (8.7%) | (4.9%) | (12.1%) | (5.8%) | (2.8%) | (11.1%) | (25.7%) | (13.5%) | (5.5%) | (11.3%) | (9.4%) | (13.5%) | (10.0%) |
| Impossible to classify* | 4 | 29 | 3 | 8 | 43 | 89 | 59 | 24 | 24 | 14 | 29 | 34 | 13 | 18 | 391 |
| (12.5%) | (20.6%) | (13.0%) | (13.1%) | (21.7%) | (22.4%) | (55.1%) | (26.7%) | (32.4%) | (14.6%) | (26.6%) | (42.5%) | (15.3%) | (24.3%) | (25.0%) | |