Caesarean Delivery Rates According to Pregnancy Characteristics and Robson Classification in Hypertension Related Pregnancy

Angeline Francis Rumintjap, Deviana Soraya Riu, Maisuri T. Chalid


Abstract


Objective: The study aimed to investigate the pregnancy characteristics of patients with hypertension related pregnancy and the rate of caesarean section in hypertension related pregnancy categorized into Robson Classification system at the Mother and Children Hospital.
Methods: This cross-sectional study design was conducted from December 1st 2018 to November 30th 2019 in one of the private Mother and Children Hospital in Makassar. Total of 156 women with hypertension related pregnancy delivered. Demographics, clinical manifestation, pregnancy outcomes were collected and analyzed using the Chi-square test.
Result: Caesarean delivery was 87.8% in our study and birth weight is significantly related to method of delivery (p=0,018). The risk of developing asphyxia of newborn was found 5.8% with higher values for HELLP syndrome (OR=9.667), severe preeclampsia (OR=7.077) and birth weight (OR=4.154). According to Robson classification, size of group 8 (5.8%), group 10 (9%) and number of caesarean delivery in group 5 (90%) were higher (should be 1.5-2%; <5%; and 50-60% in general population, respectively). All the caesarean group rate were above the general population.
Conclusion: Clinical considerations about method of delivery need to be tailored to each individual in order to avoid maternal morbidity in later date. The Robson Classification could be one of the guiding tool to assess specific subgroups of women.

Kejadian Seksio Sesaria Menurut Karakteristik Kehamilan dan Klasifikasi Robson Pada Hipertensi Dalam Kehamilan

Abstrak
Tujuan: Penelitian ini bertujuan untuk mengetahui karakteristik kehamilan pada pasien dan rasio seksio sesaria dengan hipertensi dalam kehamilan yang dikategorikan dalam sistem Klasifikasi Robson di Rumah Sakit Ibu dan Anak.
Metode: Desain potong lintang dilakukan pada 1 Desember 2018 hingga 30 November 2019 pada salah satu Rumah Sakit Ibu dan Anak swasta di Makassar. Total 156 perempuan dengan hipertensi dalam kehamilan mengalami persalinan. Demografi, manifestasi klinis dan luaran kehamilan dikumpulkan dan dianalisis. Rasio seksio sesaria secara umum pada tiap grup Robson dihitung, demikian pula dengan kontribusi tiap grup terhadap rasio seksio sesaria secara umum.
Hasil: Seksio sesaria ditemukan pada 87% pasien dan berat badan lahir secara signifikan terkait dengan metode persalinan (p=0,018). Asfiksia bayi baru lahir ditemukan 5,8% pada penelitian dengan risiko yang meningkat pada sindrom HELLP (OR=9,667), preeklampsia berat (OR=7,077) dan berat badan lahir (OR=4,154). Menurut klasifikasi Robson, ukuran grup 8 (5.8%), grup 10 (9%) dan rasio seksio sesaria di grup 5 (90%) lebih tinggi dibandingkan populasi umum. Seluruh rasio seksio sesaria lebih tinggi dibandingkan populasi umum.
Kesimpulan: Pertimbangan klinis mengenai metode persalinan perlu dikhususkan pada masing-masing individual untuk menghindari morbiditas maternal di kemudian hari. Klasifikasi Robson dapat menjadi alat kontrol untuk melakukan evaluasi pada tiap grup.

Kata kunci: Hipertensi; Kehamilan; Seksio sesaria; Klasifikasi Robson.


Keywords


Hypertension; Pregnancy; Caesarean delivery; Robson classification

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References


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DOI: http://dx.doi.org/10.24198/obgynia.v5i1.364

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