Taxas de cesárea em Chapecó Santa Catarina: uma análise da classificação de dez grupos de Robson

Abstract

Caesarean section is a surgery that, with precise indications and when performed safely, contributes to the reduction of maternal and neonatal mortality. However, it has been used indiscriminately and due to high cesarean rates worldwide, the World Health Organization has advocated the adoption of the Robson Classification to try to reduce rates of cesarean delivery in unnecessary ways. This study aimed to know the Robson classification of pregnant women submitted to cesarean section in Chapecó, Santa Catarina. This is an exploratory descriptive quantitative research, with multivariate descriptive statistical approach, of type analysis of factor. The research was carried out in the Municipal Health Department of Chapecó, in the Epidemiological Surveillance, for the collection of documentary data in the Declarations of Live Births. These data fed the Robson Spreadsheet which was filled with the total number of cesareans in each group, the total number of deliveries in each group, the size of the group, in percentage, in relation to the total number of deliveries, the percentage of cesareans in each group group and the absolute and relative contribution of each group to the cesarean rate. The result of this research showed that the general rate of cesarean section of the pregnant women of Chapecó, in the year 2017, was 66.3%. In the establishment, the public rate was 58%, in the private establishment this rate reached 91.6%. The Robson group that contributed most to the absolute rate of cesarean section was 5 (multiparous with one or more previous cesarean, single, cephalic, 37 weeks), with a rate of 22.1% and 2 (nulliparous, single, cephalic, 37 weeks, induced labor or cesarean section before labor), with a rate of 19.5%. These groups also contributed to the cesarean rate in the majority of the public, group 5 with 21.1% and group 2 with 14.7%, and in the private establishment, group 5 with 25.5% and group 2 with 33.7%. This result allows specific education actions to be performed and directed to the group of women who, predominantly, undergo unnecessary caesarean sections. It also instigates Nursing and Medicine courses to plan professional training in health, with a view to changing the profile of reality.