CAESAREAN SECTION RATES AT THE HOSPITAL MATERNITY: A CASE STUDY IN MOROCCO USING THE ROBSON CLASSIFICATION SYSTEM

Caesarean section rates continue to rise worldwide, although the reasons appear to be multiple and complex. To better understand and control the phenomenon, many countries have started to use the 10-group classification of Caesarean sections, also known as the Robson classification. This classification will monitor and compare standardized, reliable, consistent, and indication-oriented Cesarean section rates. As part of a quality improvement initiative aimed at rationalizing Caesarean section rates, our descriptive and retrospective study was conducted on a population of parturients who had given birth by Caesarean section at the maternity ward of the CheikhKhalifa Hospital in Casablanca. Our study was conducted over ten months. We listed all Caesarean deliveries and classified them into ten groups (Robsons classification) to identify the contribution of each group to the overall Caesarean rate and to explain potential discrepancies, the analysis of which enabled us to propose recommendations. Our study involved 890 cases, 541 of which required a Caesarean section, a rate of 61%, which is higher than the rate recommended by the WHO (15%) and the national rate (21%). This classification system allowed us to identify group 10 as the most contributing to the overall Caesarean section rate (43.4%). This group included singleton pregnancies with the cephalic presentation, gestational age < 37 weeks, and a scarred uterus. This groups relative size and Caesarean section rate were 68% and 63%, respectively. Caesarean section is a non-negligible surgical procedure with both maternal and neonatal risks. Robsons classification helps to ensure that women who need Caesarean sections receive them.