Abstract
Author(s): Lech Wojewodzic (ABCDEF), SÅawomir Suchocki (ADEF), RafaÅ Mazurek (BE),Joanna LipieÅ (B), Maria Jakubiak-Rusak (B)
Introduction. In many obstetric situations, cesarean sectionis a life-saving procedure, and its guaranteed availability iscontained in the Millennium Development Goals of the WorldHealth Organization. It is also a surgical procedure that is notfree of complications. That is why its overuse can be harmfulboth to women and to neonates.Aim. Analysis of cesarean sections performed in 2010–2015in the Specialist Gynecologic and Obstetric Hospital in Wa?-brzych using the Robson classification.Materials and methods. A retrospective analysis involved allwomen who gave birth by cesarean section in the SpecialistGynecologic and Obstetric Hospital in Wa?brzych from Janu-ary 1 2010 to December 31 2015. Each patient was classifiedinto one of 10 groups according to Robson. An overall cesa-rean section rate and cesarean section rates for individualgroups were calculated, and trends in the fluctuation of theserates in individual groups over the investigated 6-year periodwere presented.Results. The cesarean section rate in 2010–2015 amountedto 24.76. There were 11,315 childbirths, 2801 of which en-ded with a cesarean section. Nulliparous women with termcephalic pregnancy in spontaneous labor (Robson’s Group 1)and multiparous women with single term cephalic pregnan-cy with a previous cesarean section (Group 5) accounted for44.8% of all cases of cesarean sections in 2010, and 52.6%in 2015. This increase resulted from a markedly higher rateof cesarean sections in Group 5 (women after at least onecesarean section).Conclusions. It seems that all attempts to rationalize thecesarean section rate should focus on proper classification ofwomen with a history of cesarean section (Group 5) to na-tural childbirths. The number of women with a history ofcesarean section that do not consent to natural labor incre-ases markedly. The optimization of medical indications for theprimary cesarean delivery, including extra-obstetric ones (Gro-ups 1 and 2), is a more important matter since this willdecrease the number of women with a history of cesareansection (Group 5).