Validation of a statistical toolkit based on the ten-group Robson Classification of cesarean delivery

Abstract

Objective: To assess the validity of a statistical toolkit based on the original ten-group Robson Classification of cesarean delivery.

Methods: A retrospective pilot study at Al Wakra Hospital in Doha, Qatar, was conducted from June 1 to June 30, 2017, involving consecutive women undergoing cesarean delivery, using a three-stage approach. A Microsoft Excel-based toolkit was developed by dividing each of the 10 groups of the original Robson Classification into clinical groups and subgroups. A critical review of the toolkit was then undertaken by four independent physicians based on different potential clinical scenarios that could culminate in cesarean delivery in each Robson group. The toolkit was validated by populating it with the data of the cesarean deliveries of the women involved in the study.

Results: The data from cesarean deliveries of 153 women were utilized in the pilot study. The toolkit catered for and successfully accommodated 94.8% of the cases without any need for change. The remaining 5.2% of cases required additional adjustments in the toolkit. The toolkit provided instant access to important data about the labor and delivery which could be used for audit and research purposes and ultimately for service improvement.

Conclusion: The toolkit significantly improved the clinical efficacy of the Robson Classification as a potential statistical tool for comparison of local and international data.

Keywords: Cesarean delivery rate; Robson Classification; Ten-group Robson Classification; Toolkit; WHO statement on cesarean section rates; World Health Organization.