الفهرس 
Cesarean SectionOnly 14 pages are availabe for public view
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Abstract
Background: Cesarean delivery has become the most common obstetric surgical intervention worldwide. It is a life-saving intervention for both the mother and her child when vaginal delivery is contraindicated or carries maternal and fetal complications. Aim of the Work: to assess the indications of CS in ASUMH according to Robson criteria and its relation to maternal & neonatal outcomes. Patients and Methods: This cohort study was conducted at Ain Shams Maternity University Hospital (ASUMH), on all pregnant ladies who delivered in-between December 2018 to December 2019 and including 9159 participants. A complete-case analysis was conducted after exclusion of cases with incomplete data and missing variables. All ladies were classified according to RTGCS into 10 groups. Results: The majority of participants were classified as group 5 (28%), followed by group 10 (21%), then group 3 (17%). The least common groups were group 9 (0.8%), followed by group 6 (1%). The highest number of participants with VD was among Robson group 3, 1 and 10, respectively, while the lowest number was among Robson group 9. On the other hand as regard to CS most of participants were among Robson group 5, 10 and 2, respectively, while the lowest number of CS was performed among participants of Robson group 9 and 6. After weighing the number of those who had CS per group, the CS rate was the highest among Robson groups 9, followed by 5 then 6, while it was the lowest rate among Robson group 3. Concerning the rate of CS among each group relative to the total number of CS and total number of births, Robson groups 5 and 10 were the two most contributing groups, whilst the least was group 9. The most commonly reported indication of CS was previous CS, representing approximately 75.2% of causes, followed by hypertensive disorders including HELLP and preeclampsia 16.3%. The least common cause was ruptured uterus, which barely affected 0.6% of the cases. Conclusion: It would be useful to carry out awareness campaigns regarding the benefits of vaginal delivery and complications of CS. In order to decrease the cesarean rate in Egypt, especially in the primigravida and in those with previous CS avoid the first CS and wait for the natural spontaneous labor. Break the paradigm “once cesarean always cesarean” and include the VBAC in care protocol.