Evaluation of caesarean rates according to Robson classification using a newly developed smart phone application in a tertiary centre in Sri Lanka: Comparative study

Objective: Caesarean section (CS) rates are increasing in Sri Lanka. More than half of births will occur through CS by 2025. CS should be medically indicated to reduce maternal morbidity. Robson classification is useful in assessing the indications for CS. It is difficult to obtain high-quality prospective data using traditional data collection methods. We intend to assess the use of new technology for this purpose. Design: A prospective audit, comparing smart phone app based data collection with the previous studies. Setting: Professorial unit De Soysa Hospital for Women (DSHW) in Sri Lanka Study population 1712 deliveries were taken for the study from April to October 2019 Methods: We used the RobsApp® which is a newly developed smart phone application for prospective data collection according to the Robson classification. This data is compared with Robson standards and previous traditional data collection methods. Outcome measures The caesarean section rates according to each Robson category and data quality. Results: The quality of data gathered matched the recommendations by Robson guidance. The overall CS rate was 33.0%. Majority of the CS were carried out for Robson category 5a. Breech presentation accounted for 11.6% of CSs. Emergency CS contributed to 49.6% with CTG abnormalities being the most frequent indication. Conclusions: RobsApp® is a convenient method for prospective data collection which allows achievement of the data quality recommended by the Robson guidance. The CS rates are rising in professorial unit DSHW. Increasingly CS are being performed for reasons other than for past sections.