Cesarean Section Patterns Based on the Robson Classification in a Regional General Hospital

Abstract

Objectives: To quantify cesarean section use and identify the Robson groups contributing most to the institutional cesarean rate among all deliveries.

Methods: This retrospective cross-sectional study included all eligible and complete delivery records at Panembahan
Senopati Regional General Hospital from January 1, 2022, through December 31, 2023. Delivery mode and Robson group were summarized using group size, group-specific cesarean section rate, absolute contribution, and relative contribution. Associations were assessed using chi-square tests and exploratory modified Poisson regression with robust standard errors.

Results: Among 1,178 deliveries, 763 (64.8%) were vaginal and 415 were cesarean, yielding a cesarean rate of 35.2% (95% confidence interval, 32.6-38.0%). Groups 2, 5, and 4 contributed 27.2%, 21.7%, and 17.3% of all cesareans, respectively, and together accounted for 66.3%. Group 5 had the highest group-specific rate (69.8%). Previous cesarean section showed the strongest adjusted association with cesarean delivery (adjusted prevalence ratio, 3.02; 95% confidence interval, 2.52-3.61).

Conclusion: Cesarean use was concentrated in Groups 2, 5, and 4. Future audits should distinguish induction from prelabor cesarean delivery, review primary cesarean pathways, and support individualized management after previous cesarean.

Keywords: cesarean section, clinical audit, delivery, Robson classification.