Comparative Analysis of Caesarean Delivery Rates in a Tertiary and a Secondary Hospitals Using Robson Ten Group Classification

Background: There is no justification for any reason to have a caesarean delivery (CD) rate higher than 10–15%. CD rates higher than 10% are not associated with substantial decrease in maternal and neonatal mortality rates. Robson Group Classification System has the advantage of analyzing the caesarean delivery rate in well-defined sub-groups of women that are totally inclusive and mutally exclusive.
Objective: The aim of the current work was to make comparative analysis of increasing trends of caesarean delivery in two hospitals at Assiut Governorate in Egypt.
Patients and methods: This retrospective cross-sectional study included a total of 2702 cases, attending for delivery at Assiut University Hospital; a tertiary hospital and Assiut Police Hospital; a secondary hospital, both present in Assiut Governorate. This study was conducted over 3-month between Jan 2016 to Mar 2016. 
Results: Robson Group 5 constituted the most in both hospitals regarding the relative size of the group with higher and significant percentage at the secondary hospital (53%) compared to (32.3%) at the tertiary one. Robson Group 5 contributed the most in both hospitals regarding the overall CD rate with higher and significant percentage at the secondary hospital (74.8%) compared to (49.4%) at the tertiary one. Robson Group 5 also contributed the most in both hospitals regarding the absolute contribution rate of all deliveries with higher and significant percentage at the secondary hospital (50%) compared to (28.7) at the tertiary one.
Conclusion: On the basis of the study, TGCS is only a starting point, but it is important to have a common starting point. Having implemented TGCS, we have concluded that Group 5 (previous caesarean delivery) is the largest of the overall CD rate in both secondary and tertiary hospitals.