A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it.
A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it.
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DOI：
10.1371/journal.pone.0097769
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Torloni MR
中科院分区：
文献类型：
--
作者：
Betrán AP;Vindevoghel N;Souza JP;Gülmezoglu AM;Torloni MR
在没有明确了解其主要驱动因素和后果的情况下，全球剖腹产率继续上升。缺乏一个标准化的国际公认的分类系统来监测和比较CS率是更好地了解这一趋势的障碍之一。Robson的10组分类是基于简单的产科参数（胎次、既往CS、胎龄、分娩开始、胎儿呈现和胎儿数量），不涉及CS的指征。这种分类在过去几年在许多国家变得非常流行。我们进行了一次系统的回顾，以综合用户在实施这一分类和建议的调整方面的经验。检索了四个电子数据库。采用了三步专题综合法和定性元总结法。鉴定出232份独特的报告，选择97份进行全文评价，73份纳入。这些出版物报道了来自31个国家的3300多万妇女使用罗布森分类的情况。根据用户的反馈，该分类方法的主要优点是简单、健壮、可靠和灵活。然而，数据缺失、对女性的错误分类以及对分类的核心变量缺乏定义或共识是挑战。为了改善当地使用的分类，并减少组内的异质性，建议对10个组中的每个组进行若干细分。第5组（有CS病史的女性）收到的建议最多。罗布森分类法的使用在世界范围内迅速而自发地增加。尽管存在一些限制，但这种分类很容易实现和解释。一些建议的修改可能有助于各机构和国家努力实施《公约》。
Caesarean sections (CS) rates continue to increase worldwide without a clear understanding of the main drivers and consequences. The lack of a standardized internationally-accepted classification system to monitor and compare CS rates is one of the barriers to a better understanding of this trend. The Robson's 10-group classification is based on simple obstetrical parameters (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses) and does not involve the indication for CS. This classification has become very popular over the last years in many countries. We conducted a systematic review to synthesize the experience of users on the implementation of this classification and proposed adaptations. Four electronic databases were searched. A three-step thematic synthesis approach and a qualitative metasummary method were used. 232 unique reports were identified, 97 were selected for full-text evaluation and 73 were included. These publications reported on the use of Robson's classification in over 33 million women from 31 countries. According to users, the main strengths of the classification are its simplicity, robustness, reliability and flexibility. However, missing data, misclassification of women and lack of definition or consensus on core variables of the classification are challenges. To improve the classification for local use and to decrease heterogeneity within groups, several subdivisions in each of the 10 groups have been proposed. Group 5 (women with previous CS) received the largest number of suggestions. The use of the Robson classification is increasing rapidly and spontaneously worldwide. Despite some limitations, this classification is easy to implement and interpret. Several suggested modifications could be useful to help facilities and countries as they work towards its implementation.
DOI：
10.1016/s1701-2163(16)34566-2
发表时间：
2010-07-01
影响因子：
1.8
作者：
Allen, Victoria M.;Baskett, Thomas F.;O'Connell, Colleen M.
通讯作者：
O'Connell, Colleen M.
影响因子：
158.5
作者：
ANDERSON, GM;LOMAS, J
通讯作者：
LOMAS, J