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Robson Ten Group Classification System

The The Robson Ten Group Classification System (TGCS) is a comprehensive framework used to compare perinatal events and outcomes. This system categorizes all pregnant women into one of ten distinct groups, each mutually exclusive and collectively exhaustive. The classification is based on five fundamental obstetric characteristics that are routinely collected for all maternity cases: 

  1. Parity 
  2. Onset of labour 
  3. Gestational age
  4. Fetal presentation 
  5. Number of foetuses 

Key Features of the Robson TGCS: 

  • Simple and Robust: The system is straightforward to use and universally applicable. 
  • Reproducible: Ensures consistent categorization across different healthcare settings. 
  • Clinically Relevant: Directly applicable to clinical practice, enhancing its practical utility. 
  • Prospective: Allows for the immediate classification of every woman admitted for delivery based on basic obstetric characteristics. 

The Robson TGCS can be employed to analyse all labour events and outcomes, considering significant epidemiological variables. It has been extensively used worldwide to study caesarean section (CS) rates. Recognizing its value, the World Health Organization (WHO) endorsed the Robson TGCS in 2015 as the global standard for assessing, monitoring, and comparing CS rates both within and between healthcare facilities over time. 

In Ireland, the Robson TGCS has been endorsed by the Institute of Obstetricians and Gynaecologists and the Health Service Executive Clinical Care Programme in Obstetrics and Gynaecology. 

Group

Group Description 

Number of CS in group

Number of women in group

Size of group %

C/S rate in group %

Contribution of each group

All

 

21077

53433

 

39.4

 

1

Nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation in spontaneous labour

1178

7328

13.7

16.1

2.2

2

Nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced or were delivered by CS before labour

5976

12120

22.7

49.3

11.2

3

Multiparous women without a previous CS, with a single cephalic pregnancy, ≥37 weeks gestation in spontaneous labour

202

9492

17.8

2.1

0.4

4

Multiparous women without a previous CS, with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced or were delivered by CS before labour

1608

9531

17.8

16.9

3.0

5

All multiparous women with at least one previous CS, with a single cephalic pregnancy, ≥37 weeks gestation

7716

8993

16.8

85.8

14.4

6

All nulliparous women with a single breech pregnancy

1129

1177

2.2

95.9

2.1

7

All multiparous women with a single breech pregnancy including women with previous CS(s)

922

1000

1.9

92.2

1.7

8

All multiple pregnancies (including previous CS)

692

915

1.7

75.6

1.3

9

All women with a single pregnancy with a transverse or oblique lie, including women with previous uterine scars

240

243

0.5

98.8

0.4

10

All singleton, cephalic,<37 (including previous CS)

1414

2634

4.9

53.7

2.6

National Perinatal Epidemiology Centre (NPEC)

Dept. of Obstetrics and Gynaecology, 5th Floor, Cork University Maternity Hospital, Wilton, Cork,

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