Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia
Background. Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives. The objective of this analysis was...
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Wiley
2020-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2020/5620987 |
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| author | Margo S. Harrison Tewodros Liyew Ephrem Kirub Biruk Teshome Andrea Jimenez-Zambrano Margaret Muldrow Teklemariam Yarinbab |
| author_facet | Margo S. Harrison Tewodros Liyew Ephrem Kirub Biruk Teshome Andrea Jimenez-Zambrano Margaret Muldrow Teklemariam Yarinbab |
| author_sort | Margo S. Harrison |
| collection | DOAJ |
| description | Background. Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives. The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4. Methods. This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019. Results. Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by “failed induction or augmentation,” which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by “failed induction or augmentation.” In multivariable modeling of Robson Group 2, having a labor duration of “not applicable” increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)). Conclusion. Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity. |
| format | Article |
| id | doaj-art-e4201c42538845af947e60a868452555 |
| institution | Kabale University |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2020-01-01 |
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| spelling | doaj-art-e4201c42538845af947e60a8684525552025-02-03T05:52:42ZengWileyObstetrics and Gynecology International1687-95891687-95972020-01-01202010.1155/2020/56209875620987Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, EthiopiaMargo S. Harrison0Tewodros Liyew1Ephrem Kirub2Biruk Teshome3Andrea Jimenez-Zambrano4Margaret Muldrow5Teklemariam Yarinbab6Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USAMizan-Tepi University Teaching Hospital, Aman, Bench Maji Zone, EthiopiaMizan-Tepi University Teaching Hospital, Aman, Bench Maji Zone, EthiopiaMizan-Tepi University Teaching Hospital, Aman, Bench Maji Zone, EthiopiaDepartment of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USAVillage Health Partnership, Denver, CO, USAMizan-Tepi University Teaching Hospital, Aman, Bench Maji Zone, EthiopiaBackground. Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort. Objectives. The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4. Methods. This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019. Results. Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by “failed induction or augmentation,” which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by “failed induction or augmentation.” In multivariable modeling of Robson Group 2, having a labor duration of “not applicable” increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)). Conclusion. Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity.http://dx.doi.org/10.1155/2020/5620987 |
| spellingShingle | Margo S. Harrison Tewodros Liyew Ephrem Kirub Biruk Teshome Andrea Jimenez-Zambrano Margaret Muldrow Teklemariam Yarinbab Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia Obstetrics and Gynecology International |
| title | Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia |
| title_full | Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia |
| title_fullStr | Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia |
| title_full_unstemmed | Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia |
| title_short | Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia |
| title_sort | use of cesarean birth among robson groups 2 and 4 at mizan tepi university hospital ethiopia |
| url | http://dx.doi.org/10.1155/2020/5620987 |
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