Analysis of Caesarean Section Trends in a Northern Nigerian Teaching Hospital Using Modified Robson Classification

Abstract

Background: Caesarean section (CS) rate is a key indicator of the quality of obstetric care within a health facility or region. Although rates are generally reported to be low in Sub-Saharan Africa, an increasing trend has been observed in many tertiary hospitals, including those in Nigeria. The contributing factors are multifactorial and sometimes controversial, and there is often no standardized method for comparison across settings. The Robson classification has been recommended as a uniform tool for assessing and comparing CS rates, but its use remains limited in our environment. This study aimed to determine the trend of CS rates over a five-year period and to evaluate the indications for CS using a modified Robson classification.

Methodology: This retrospective cross-sectional study was conducted at Ahmadu Bello University Teaching Hospital, Zaria. Delivery records from January 2016 to December 2020 were reviewed, with a retrieval rate of 82%. Annual CS rates were calculated, and indications were categorized using the modified Robson classification. Ethical approval was obtained from the hospital's research and ethics committee.

Results: The overall CS rate was 28%, with a rising trend from 21% in 2016 to 31.2% in 2020. The highest CS rates were observed in Robson Groups 9, 7, and 5. Notably, the CS rate among women with a previous CS was 70%.

Conclusion: CS rates increased steadily over the study period. The Robson classification proved to be a practical and reproducible tool for evaluating and comparing CS rates across settings.