Background: Robson, proposed a new classification system, the Robson’s Ten-Group Classification System to allow
critical analysis according to characteristics of pregnancy. The objective was to describe caesarean rates in an urban
health centre in Dakar using Robson’s Ten groups classification
Methods: This study was performed in Philippe Senghor health centre in Dakar (Senegal), a secondary health centre
that performs CS since 2011. Before this date, only midwifes performed deliveries in this centre. The study took place
between 1 January and 31 December 2013. All patients who delivered during this period by CS were included.
Women were classified in 10 groups according to Robson’s classification, using maternal characteristics and
obstetrical history. For each group, we calculated its relative size and its contribution to the overall caesarean rate.
Results: The overall rate of caesarean was 18.2%. The main contributors to the overall caesarean rate were
primiparous women in spontaneous labour (group 1) and women with previous caesarean section (group 5). Further
analysis of group 1 showed that more than half of CS indications in this group were fetal-pelvic disproportion in
55.2% and fetal hypoxia in 27%.
Conclusion: The Robson’s classification is easy to use. Each maternity unit can compare its rates with those of units
with similar level, to find whether some groups of women have very high rates of caesarean sections. Attention
should be made because CS rates is rising up and will be problematic in our low resource countries. It is time to
implement obstetric audits to lower the CS rates.