Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar

Salma Abdi Mahmoud; Ali Makame Ussi; Rashid Saleh Khamis; Said Ali Said; Chukwuma Okafor; Mansab Ramadhan Mansab; Muhiddin Abdi Mahmoud; Mwanaisha Juma Fakih; Shuwena Abdalla Hamad; Rahma Mussa Ali; Ali Said Yussuf; Sabra Salim Masoud; Kamilya Ali Omar; Ummulkulthum Omar Hamad; Hassanat Mohammed Abdallah; Zeyana Abdulaziz Ibrahim; Amina Idrissa Ahmada; Alawiya Abubakar Ahmed; Fatma Mrisho Haji; Aziza Ali Haji; Ibrahim Shaaban Salum; Asya Mohammed Ali; Ali Juma Hassan; Aysha Mwalim Omar; Chausiku Jumbe Darwesh; Sabrina Bashir Mohamed

doi:doi:10.11648/j.jgo.20231103.13

Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar

Salma Abdi Mahmoud, Ali Makame Ussi, Rashid Saleh Khamis, Said Ali Said, Chukwuma Okafor, Mansab Ramadhan Mansab, Muhiddin Abdi Mahmoud, Mwanaisha Juma Fakih, Shuwena Abdalla Hamad, Rahma Mussa Ali, Ali Said Yussuf, Sabra Salim Masoud, Kamilya Ali Omar, Ummulkulthum Omar Hamad, Hassanat Mohammed Abdallah, Zeyana Abdulaziz Ibrahim, Amina Idrissa Ahmada, Alawiya Abubakar Ahmed, Fatma Mrisho Haji, Aziza Ali Haji, Ibrahim Shaaban Salum, Asya Mohammed Ali, Ali Juma Hassan, Aysha Mwalim Omar, Chausiku Jumbe Darwesh, Sabrina Bashir Mohamed

Published in Journal of Gynecology and Obstetrics (Volume 11, Issue 3)

Received: 15 June 2023 Accepted: 3 July 2023 Published: 11 July 2023

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Abstract

Introduction: There is a rising concern regarding the escalating rates of caesarean section (CS) in various countries, including Tanzania. This study aimed to evaluate the rate of CS by using Ten-Group Robson Classification system at the obstetric unit of Mnazi Mmoja Hospital, Zanzibar. Materials and Methods: Observational retrospective study was conducted involving 56,314 women who gave birth at the obstetric unit of Mnazi Mmoja Teaching Hospital between January 2018 and December 2022. Relevant information pertaining to the study participants was retrieved from their respective delivery records. Data analysis was performed using SPSS Statistics for Windows, version 10. Results: The CS rate was 65%, among the different groups, the most significant contributors to the CS rate were as follows: multiparous women with previous CS, single, cephalic, term (group 5) accounted for 16.9%; nulliparous women and women with the preterm single cephalic, term (group 10) accounted for 13.8%; single cephalic term multiparous women in spontaneous labour (group 3) accounted for 13.5%; and nulliparous single cephalic, term, with spontaneous labour (group 1) accounted for 12.6%. The most common indication for CS was previous CS (10,571 cases; 28.8%), followed by hypertensive disorders (7,735 cases; 21.1%) and poor progress in labour (6,692 cases; 18.3%). The analysis of maternal outcomes was 204 maternal deaths, cases of Post partum haemorrhage (PPH) (22.6%), wound infection (24%) and cesarean hysterectomy (15.2%). Regarding neonatal outcomes, stillbirth accounted for 46.6%, lower Apgar Score 28.9% and Neonatal sepsis 24.5%. Conclusion: We observed a significant increase in the CS rate at Mnazi Mmoja Hospital. Based on our analysis of Robson classification and with maternal and neonatal outcomes, it is evident that improvements in labor management at the hospital are necessary. By prioritizing this enhancement, we can strive to optimize maternal and neonatal care, leading to healthier outcomes for both mothers and their babies.

Published in	Journal of Gynecology and Obstetrics (Volume 11, Issue 3)
DOI	10.11648/j.jgo.20231103.13
Page(s)	73-79
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cesarean Section, Maternal Outcome, Neonatal Outcome, Robson 10-Group Classification System

References

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[6]	Mittal P, Pandey D, Suri J, Bharti R (2020). Trend Prediction for Cesarean Deliveries Based on Robson Classification System at a Tertiary Referral Unit of North India. J Obstet Gynaecol India 70: 111–118 doi: 10.1007/s13224-019-01275-7.
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[11]	Eftekharian C, Husslein PW, Lehner R (2021). Cesarean Section Rate and Perinatal Outcome Analyses According to Robson’s 10-Group Classification System. Matern Child Health J 25: 1474–1481 doi: 10.1007/s10995-021-03183-7.
[12]	Robson Classification: Implementation Manual. https://www.who.int/publications/i/item/9789241513197. Accessed 4 Jun 2023.
[13]	Pourshirazi M, Heidarzadeh M, Taheri M, Esmaily H, Babaey F, Talkhi N, Gholizadeh L (2022). Cesarean delivery in Iran: a population-based analysis using the Robson classification system. BMC Pregnancy Childbirth. doi.org/10.1186/S12884-022-04517-1.
[14]	Savchenko J, Ladfors L, Hjertberg L, Hildebrand E, Brismar Wendel S (2022). A step towards better audit: The Robson Ten Group classification system for outcomes other than cesarean section. Acta Obstet Gynecol Scand 101: 827–835 doi: 10.1111/aogs.14350.
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[16]	Abdallah W, Abi Tayeh G, Cortbaoui E, et al (2022). Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification. Int J Gynaecol Obstet 156: 298–303 doi: 10.1002/ijgo.13653.
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[18]	Bello OO, Agboola AD (2022). Utilizing the Robson 10-Group Classification System as an Audit Tool in Assessing the Soaring Caesarean Section Rates in Ibadan, Nigeria. J West Afr Coll Surg 12: 64 doi: 10.4103/jwas.jwas_43_22.
[19]	Zuleta-Tobón JJ (2021). Demonstration of the application of the global cesarean section rate model (C-Model) and the Robson Classification to estimate and characterize excess numbers of institutional c-sections. Rev Colomb Obstet Ginecol 72: 271–281 doi: 10.18597/rcog.3649.
[20]	Alsulami SM, Ashmawi MT, Jarwan RO, Malli IA, Albar SK, Al-Jifree HM (2020). The Rates of Cesarean Section Deliveries According to Robson Classification System During the Year of 2018 Among Patients in King Abdul-Aziz Medical City, Jeddah, Saudi Arabia. Cureus. doi.org/10.7759/CUREUS.11529.
[21]	Manu A, Billah SM, Williams J, et al (2022). Institutionalising maternal and newborn quality-of-care standards in Bangladesh, Ghana and Tanzania: a quasi-experimental study. BMJ Glob Health. doi.org/10.1136/bmjgh-2022-009471.
[22]	Rookesh Z, Kaviani M, Zarshenas M, Akbarzadeh M (2021). Comparison of Maternal-Infant Attachment in Cesarean Delivery Based on Robson Classification: A Cross-Sectional Study. Iran J Nurs Midwifery Res 26: 500–507 doi: 10.4103/ijnmr.IJNMR_230_19.
[23]	D’Agostini Marin DF, da Rosa Wernke A, Dannehl D, de Araujo D, Koch GF, Marçal Zanoni K, Baschirotto Dorigon Coral K, Valeriano Guimarães N, Feuerschuette O, Pinto Moehlecke Iser B (2022). The Project Appropriate Birth and a reduction in caesarean section rates: an analysis using the Robson classification system. BJOG 129: 72–80 doi: 10.1111/1471-0528.16919.

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Salma Abdi Mahmoud, Ali Makame Ussi, Rashid Saleh Khamis, Said Ali Said, Chukwuma Okafor, et al. (2023). Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. Journal of Gynecology and Obstetrics, 11(3), 73-79. https://doi.org/10.11648/j.jgo.20231103.13

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ACS Style

Salma Abdi Mahmoud; Ali Makame Ussi; Rashid Saleh Khamis; Said Ali Said; Chukwuma Okafor, et al. Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. J. Gynecol. Obstet. 2023, 11(3), 73-79. doi: 10.11648/j.jgo.20231103.13

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AMA Style

Salma Abdi Mahmoud, Ali Makame Ussi, Rashid Saleh Khamis, Said Ali Said, Chukwuma Okafor, et al. Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. J Gynecol Obstet. 2023;11(3):73-79. doi: 10.11648/j.jgo.20231103.13

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@article{10.11648/j.jgo.20231103.13,
  author = {Salma Abdi Mahmoud and Ali Makame Ussi and Rashid Saleh Khamis and Said Ali Said and Chukwuma Okafor and Mansab Ramadhan Mansab and Muhiddin Abdi Mahmoud and Mwanaisha Juma Fakih and Shuwena Abdalla Hamad and Rahma Mussa Ali and Ali Said Yussuf and Sabra Salim Masoud and Kamilya Ali Omar and Ummulkulthum Omar Hamad and Hassanat Mohammed Abdallah and Zeyana Abdulaziz Ibrahim and Amina Idrissa Ahmada and Alawiya Abubakar Ahmed and Fatma Mrisho Haji and Aziza Ali Haji and Ibrahim Shaaban Salum and Asya Mohammed Ali and Ali Juma Hassan and Aysha Mwalim Omar and Chausiku Jumbe Darwesh and Sabrina Bashir Mohamed},
  title = {Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {11},
  number = {3},
  pages = {73-79},
  doi = {10.11648/j.jgo.20231103.13},
  url = {https://doi.org/10.11648/j.jgo.20231103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20231103.13},
  abstract = {Introduction: There is a rising concern regarding the escalating rates of caesarean section (CS) in various countries, including Tanzania. This study aimed to evaluate the rate of CS by using Ten-Group Robson Classification system at the obstetric unit of Mnazi Mmoja Hospital, Zanzibar. Materials and Methods: Observational retrospective study was conducted involving 56,314 women who gave birth at the obstetric unit of Mnazi Mmoja Teaching Hospital between January 2018 and December 2022. Relevant information pertaining to the study participants was retrieved from their respective delivery records. Data analysis was performed using SPSS Statistics for Windows, version 10. Results: The CS rate was 65%, among the different groups, the most significant contributors to the CS rate were as follows: multiparous women with previous CS, single, cephalic, term (group 5) accounted for 16.9%; nulliparous women and women with the preterm single cephalic, term (group 10) accounted for 13.8%; single cephalic term multiparous women in spontaneous labour (group 3) accounted for 13.5%; and nulliparous single cephalic, term, with spontaneous labour (group 1) accounted for 12.6%. The most common indication for CS was previous CS (10,571 cases; 28.8%), followed by hypertensive disorders (7,735 cases; 21.1%) and poor progress in labour (6,692 cases; 18.3%). The analysis of maternal outcomes was 204 maternal deaths, cases of Post partum haemorrhage (PPH) (22.6%), wound infection (24%) and cesarean hysterectomy (15.2%). Regarding neonatal outcomes, stillbirth accounted for 46.6%, lower Apgar Score 28.9% and Neonatal sepsis 24.5%. Conclusion: We observed a significant increase in the CS rate at Mnazi Mmoja Hospital. Based on our analysis of Robson classification and with maternal and neonatal outcomes, it is evident that improvements in labor management at the hospital are necessary. By prioritizing this enhancement, we can strive to optimize maternal and neonatal care, leading to healthier outcomes for both mothers and their babies.},
 year = {2023}
}

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TY  - JOUR
T1  - Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar
AU  - Salma Abdi Mahmoud
AU  - Ali Makame Ussi
AU  - Rashid Saleh Khamis
AU  - Said Ali Said
AU  - Chukwuma Okafor
AU  - Mansab Ramadhan Mansab
AU  - Muhiddin Abdi Mahmoud
AU  - Mwanaisha Juma Fakih
AU  - Shuwena Abdalla Hamad
AU  - Rahma Mussa Ali
AU  - Ali Said Yussuf
AU  - Sabra Salim Masoud
AU  - Kamilya Ali Omar
AU  - Ummulkulthum Omar Hamad
AU  - Hassanat Mohammed Abdallah
AU  - Zeyana Abdulaziz Ibrahim
AU  - Amina Idrissa Ahmada
AU  - Alawiya Abubakar Ahmed
AU  - Fatma Mrisho Haji
AU  - Aziza Ali Haji
AU  - Ibrahim Shaaban Salum
AU  - Asya Mohammed Ali
AU  - Ali Juma Hassan
AU  - Aysha Mwalim Omar
AU  - Chausiku Jumbe Darwesh
AU  - Sabrina Bashir Mohamed
Y1  - 2023/07/11
PY  - 2023
N1  - https://doi.org/10.11648/j.jgo.20231103.13
DO  - 10.11648/j.jgo.20231103.13
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 73
EP  - 79
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20231103.13
AB  - Introduction: There is a rising concern regarding the escalating rates of caesarean section (CS) in various countries, including Tanzania. This study aimed to evaluate the rate of CS by using Ten-Group Robson Classification system at the obstetric unit of Mnazi Mmoja Hospital, Zanzibar. Materials and Methods: Observational retrospective study was conducted involving 56,314 women who gave birth at the obstetric unit of Mnazi Mmoja Teaching Hospital between January 2018 and December 2022. Relevant information pertaining to the study participants was retrieved from their respective delivery records. Data analysis was performed using SPSS Statistics for Windows, version 10. Results: The CS rate was 65%, among the different groups, the most significant contributors to the CS rate were as follows: multiparous women with previous CS, single, cephalic, term (group 5) accounted for 16.9%; nulliparous women and women with the preterm single cephalic, term (group 10) accounted for 13.8%; single cephalic term multiparous women in spontaneous labour (group 3) accounted for 13.5%; and nulliparous single cephalic, term, with spontaneous labour (group 1) accounted for 12.6%. The most common indication for CS was previous CS (10,571 cases; 28.8%), followed by hypertensive disorders (7,735 cases; 21.1%) and poor progress in labour (6,692 cases; 18.3%). The analysis of maternal outcomes was 204 maternal deaths, cases of Post partum haemorrhage (PPH) (22.6%), wound infection (24%) and cesarean hysterectomy (15.2%). Regarding neonatal outcomes, stillbirth accounted for 46.6%, lower Apgar Score 28.9% and Neonatal sepsis 24.5%. Conclusion: We observed a significant increase in the CS rate at Mnazi Mmoja Hospital. Based on our analysis of Robson classification and with maternal and neonatal outcomes, it is evident that improvements in labor management at the hospital are necessary. By prioritizing this enhancement, we can strive to optimize maternal and neonatal care, leading to healthier outcomes for both mothers and their babies.
VL  - 11
IS  - 3
ER  -

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Author Information

Salma Abdi Mahmoud

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Ali Makame Ussi

Department of Natural Sciences, State University of Zanzibar, Zanzibar, Tanzania
Rashid Saleh Khamis

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Said Ali Said

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Chukwuma Okafor

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Mansab Ramadhan Mansab

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Muhiddin Abdi Mahmoud

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Mwanaisha Juma Fakih

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Shuwena Abdalla Hamad

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Rahma Mussa Ali

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Ali Said Yussuf

Department of Obstetrics and Gynaecology, School of Health and Medical Sciences, State University of Zanzibar, Zanzibar, Tanzania
Sabra Salim Masoud

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Kamilya Ali Omar

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Ummulkulthum Omar Hamad

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Hassanat Mohammed Abdallah

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Zeyana Abdulaziz Ibrahim

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Amina Idrissa Ahmada

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Alawiya Abubakar Ahmed

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Fatma Mrisho Haji

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Aziza Ali Haji

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Ibrahim Shaaban Salum

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Asya Mohammed Ali

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Ali Juma Hassan

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Aysha Mwalim Omar

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Chausiku Jumbe Darwesh

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania
Sabrina Bashir Mohamed

Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, Tanzania

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APA Style

Salma Abdi Mahmoud, Ali Makame Ussi, Rashid Saleh Khamis, Said Ali Said, Chukwuma Okafor, et al. (2023). Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. Journal of Gynecology and Obstetrics, 11(3), 73-79. https://doi.org/10.11648/j.jgo.20231103.13

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ACS Style

Salma Abdi Mahmoud; Ali Makame Ussi; Rashid Saleh Khamis; Said Ali Said; Chukwuma Okafor, et al. Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. J. Gynecol. Obstet. 2023, 11(3), 73-79. doi: 10.11648/j.jgo.20231103.13

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AMA Style

Salma Abdi Mahmoud, Ali Makame Ussi, Rashid Saleh Khamis, Said Ali Said, Chukwuma Okafor, et al. Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar. J Gynecol Obstet. 2023;11(3):73-79. doi: 10.11648/j.jgo.20231103.13

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@article{10.11648/j.jgo.20231103.13,
  author = {Salma Abdi Mahmoud and Ali Makame Ussi and Rashid Saleh Khamis and Said Ali Said and Chukwuma Okafor and Mansab Ramadhan Mansab and Muhiddin Abdi Mahmoud and Mwanaisha Juma Fakih and Shuwena Abdalla Hamad and Rahma Mussa Ali and Ali Said Yussuf and Sabra Salim Masoud and Kamilya Ali Omar and Ummulkulthum Omar Hamad and Hassanat Mohammed Abdallah and Zeyana Abdulaziz Ibrahim and Amina Idrissa Ahmada and Alawiya Abubakar Ahmed and Fatma Mrisho Haji and Aziza Ali Haji and Ibrahim Shaaban Salum and Asya Mohammed Ali and Ali Juma Hassan and Aysha Mwalim Omar and Chausiku Jumbe Darwesh and Sabrina Bashir Mohamed},
  title = {Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {11},
  number = {3},
  pages = {73-79},
  doi = {10.11648/j.jgo.20231103.13},
  url = {https://doi.org/10.11648/j.jgo.20231103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20231103.13},
  abstract = {Introduction: There is a rising concern regarding the escalating rates of caesarean section (CS) in various countries, including Tanzania. This study aimed to evaluate the rate of CS by using Ten-Group Robson Classification system at the obstetric unit of Mnazi Mmoja Hospital, Zanzibar. Materials and Methods: Observational retrospective study was conducted involving 56,314 women who gave birth at the obstetric unit of Mnazi Mmoja Teaching Hospital between January 2018 and December 2022. Relevant information pertaining to the study participants was retrieved from their respective delivery records. Data analysis was performed using SPSS Statistics for Windows, version 10. Results: The CS rate was 65%, among the different groups, the most significant contributors to the CS rate were as follows: multiparous women with previous CS, single, cephalic, term (group 5) accounted for 16.9%; nulliparous women and women with the preterm single cephalic, term (group 10) accounted for 13.8%; single cephalic term multiparous women in spontaneous labour (group 3) accounted for 13.5%; and nulliparous single cephalic, term, with spontaneous labour (group 1) accounted for 12.6%. The most common indication for CS was previous CS (10,571 cases; 28.8%), followed by hypertensive disorders (7,735 cases; 21.1%) and poor progress in labour (6,692 cases; 18.3%). The analysis of maternal outcomes was 204 maternal deaths, cases of Post partum haemorrhage (PPH) (22.6%), wound infection (24%) and cesarean hysterectomy (15.2%). Regarding neonatal outcomes, stillbirth accounted for 46.6%, lower Apgar Score 28.9% and Neonatal sepsis 24.5%. Conclusion: We observed a significant increase in the CS rate at Mnazi Mmoja Hospital. Based on our analysis of Robson classification and with maternal and neonatal outcomes, it is evident that improvements in labor management at the hospital are necessary. By prioritizing this enhancement, we can strive to optimize maternal and neonatal care, leading to healthier outcomes for both mothers and their babies.},
 year = {2023}
}

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TY  - JOUR
T1  - Stepping Towards Improved Audit Quality: The Outcome of Caesarean Section Using the Robson Ten Group Classification System at Mnazi Mmoja Hospital, Zanzibar
AU  - Salma Abdi Mahmoud
AU  - Ali Makame Ussi
AU  - Rashid Saleh Khamis
AU  - Said Ali Said
AU  - Chukwuma Okafor
AU  - Mansab Ramadhan Mansab
AU  - Muhiddin Abdi Mahmoud
AU  - Mwanaisha Juma Fakih
AU  - Shuwena Abdalla Hamad
AU  - Rahma Mussa Ali
AU  - Ali Said Yussuf
AU  - Sabra Salim Masoud
AU  - Kamilya Ali Omar
AU  - Ummulkulthum Omar Hamad
AU  - Hassanat Mohammed Abdallah
AU  - Zeyana Abdulaziz Ibrahim
AU  - Amina Idrissa Ahmada
AU  - Alawiya Abubakar Ahmed
AU  - Fatma Mrisho Haji
AU  - Aziza Ali Haji
AU  - Ibrahim Shaaban Salum
AU  - Asya Mohammed Ali
AU  - Ali Juma Hassan
AU  - Aysha Mwalim Omar
AU  - Chausiku Jumbe Darwesh
AU  - Sabrina Bashir Mohamed
Y1  - 2023/07/11
PY  - 2023
N1  - https://doi.org/10.11648/j.jgo.20231103.13
DO  - 10.11648/j.jgo.20231103.13
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 73
EP  - 79
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20231103.13
AB  - Introduction: There is a rising concern regarding the escalating rates of caesarean section (CS) in various countries, including Tanzania. This study aimed to evaluate the rate of CS by using Ten-Group Robson Classification system at the obstetric unit of Mnazi Mmoja Hospital, Zanzibar. Materials and Methods: Observational retrospective study was conducted involving 56,314 women who gave birth at the obstetric unit of Mnazi Mmoja Teaching Hospital between January 2018 and December 2022. Relevant information pertaining to the study participants was retrieved from their respective delivery records. Data analysis was performed using SPSS Statistics for Windows, version 10. Results: The CS rate was 65%, among the different groups, the most significant contributors to the CS rate were as follows: multiparous women with previous CS, single, cephalic, term (group 5) accounted for 16.9%; nulliparous women and women with the preterm single cephalic, term (group 10) accounted for 13.8%; single cephalic term multiparous women in spontaneous labour (group 3) accounted for 13.5%; and nulliparous single cephalic, term, with spontaneous labour (group 1) accounted for 12.6%. The most common indication for CS was previous CS (10,571 cases; 28.8%), followed by hypertensive disorders (7,735 cases; 21.1%) and poor progress in labour (6,692 cases; 18.3%). The analysis of maternal outcomes was 204 maternal deaths, cases of Post partum haemorrhage (PPH) (22.6%), wound infection (24%) and cesarean hysterectomy (15.2%). Regarding neonatal outcomes, stillbirth accounted for 46.6%, lower Apgar Score 28.9% and Neonatal sepsis 24.5%. Conclusion: We observed a significant increase in the CS rate at Mnazi Mmoja Hospital. Based on our analysis of Robson classification and with maternal and neonatal outcomes, it is evident that improvements in labor management at the hospital are necessary. By prioritizing this enhancement, we can strive to optimize maternal and neonatal care, leading to healthier outcomes for both mothers and their babies.
VL  - 11
IS  - 3
ER  -

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