zohreh rookesh

The Robson criteria allows for standardized comparisons of data and possible driving changes in Cesarean Section (C/S) rates and complications. The aimed to compare maternal‑infant attachment in C/S based on Robson Classification.

This cross‑sectional prospective study was conducted on 369 women who had undergone C/S in Hazrate Zeinab Peace Be Upon Him (PBUH), Hafez, and Shooshtari hospitals affiliated to Shiraz University of Medical Sciences, Iran from April 2018 to March 2019. The study data were collected using a demographic form, an obstetric form, and Avant Checklist (AC) at postpartum and pre‑discharge stages. Each participant was placed in Robson classification and the attachment score was calculated in each Robson Classification, and a comparison was made among the 10 groups. The data were analyzed into the SPSS 16 software and using descriptive statistics and paired t test.

The total mean (SD) score of attachment was 38.73 (18.65) at 1–7 h postpartum and 90.52 (23.79) at pre‑discharge. The highest total mean (SD) score of attachment was observed in group 6 (86.78 (8.70) at postpartum and 118.67 (4.47) at pre‑discharge). The lowest total mean (SD) score of attachment was observed in group 10 (12.79 (2.37) at 1–7 h postpartum and 45.44 (7.99) at pre‑discharge).

Obstetric characteristics in Robson Classification, parity, previous C/S, gestational age, onset of labor, fetal presentation, and number of fetuses were effective in clarifying information. The use of this system is necessary to determine the causes of increased C/S cases in low‑income and middle‑income countries.

Cesarean section is performed to save the lives of the mother and the fetus. According to the World Health Organization (WHO), the expected cesarean section rate in different countries should be 10% - 15%, which is about 72.1% in Iran.

Therefore, due to the high prevalence of cesarean section, the present study was conducted to determine the prevalence of cesarean section based on Robson’s classification in selected hospitals of Shiraz University of Medical Sciences.

This descriptive-prospective study was conducted among 1787 women who had undergone a cesarean section in Hazrat Zeinab and Hafez hospitals of Shiraz in 2018. The data were collected by the researcher from the data recorded in the two delivery centers, and all the women were classified into 10 Robson groups. Cesarean section was calculated for each group of Robson’s classification. Data were analyzed using descriptive statistics (frequency and percentage) in SPSS, version 22.

Findings showed that 63.4% of the deliveries were performed through cesarean section, and the highest frequency (46.6%) was related to group 5, followed by group 2 (19.5%).

Given the high Prevalence of cesarean section observed in this study, it is recommended that the rate of cesarean section should be reduced in nulliparous women (group 2), and vaginal delivery should be increased after cesarean section (group 5).