Evaluation of caesarean rates according to Robson classification using a
newly developed smart phone application in a tertiary centre in Sri
Lanka: Comparative study
Abstract
Objective Caesarean section (CS) rates are increasing in Sri
Lanka. More than half of births will occur through CS by 2025. CS should
be medically indicated to reduce maternal morbidity. Robson
classification is useful in assessing the indications for CS. It is
difficult to obtain high-quality prospective data using traditional data
collection methods. We intend to assess the use of new technology for
this purpose. Design A prospective audit, comparing smart phone
app based data collection with the previous studies. Setting
Professorial unit De Soysa Hospital for Women (DSHW) in Sri Lanka
Study population 1712 deliveries were taken for the study from
April to October 2019 Methods We used the RobsApp® which is a
newly developed smart phone application for prospective data collection
according to the Robson classification. This data is compared with
Robson standards and previous traditional data collection methods.
Outcome measures The caesarean section rates according to each
Robson category and data quality. Results The quality of data
gathered matched the recommendations by Robson guidance. The overall CS
rate was 33.0%. Majority of the CS were carried out for Robson category
5a. Breech presentation accounted for 11.6% of CSs. Emergency CS
contributed to 49.6% with CTG abnormalities being the most frequent
indication. Conclusions RobsApp® is a convenient method for
prospective data collection which allows achievement of the data quality
recommended by the Robson guidance. The CS rates are rising in
professorial unit DSHW. Increasingly CS are being performed for reasons
other than for past sections.