Lichtenberg Cloo, Saar (2025) Determinants of Secondary Caesarean Sections in Robson Group 1 Pregnancies: Evaluating Labour Management and the Role of Obstetric Interventions at St. Antonius Hospital. thesis, Medicine.
Full text available on request.Abstract
Background: At St Antonius Hospital, an increasing number of women are giving birth in hospitals, benefiting from professional monitoring and medical interventions. While advances in obstetrics aim to improve maternal and fetal outcomes, they have also led to rising intervention rates, including emergency caesarean sections (CS). At St. Antonius Hospital, Utrecht, secondary CS rates are higher than the national average, particularly in low-risk nulliparous women with term, singleton pregnancies in cephalic presentation (NTSV). This study investigates factors contributing to these rates using the Robson Classification, focusing on labour augmentation, maternal and fetal outcomes, and clinical decision-making. Methods: This retrospective cohort study analysed Robson Group 1 women undergoing secondary CS at St. Antonius Hospital (Jan 2023–June 2024). Primary outcomes included indications for secondary CS and utilisation of supportive measures. Results: A total of 135 primigravida women undergoing secondary caesarean section were included in this study. The mean maternal age was 31.6 years, with a mean gestational age of 40.3 weeks. The primary indications for caesarean section were stagnation in dilation (42.2%), failure to descend (29.6%), and fetal distress (17.8%). Epidural analgesia was used in 85.9%, and oxytocin for augmentation in 87.7%. Ritodrine and fetal scalp blood sampling were underutilised in 16.6% and 62.5% of relevant cases, respectively. Conclusions: Application of the Robson criteria identified key contributors to secondary CS among low-risk (NTSV) pregnancies at St. Antonius Hospital. Optimising protocols for oxytocin, ritodrine, and fetal scalp blood sampling may improve labour management and reduce unnecessary CS.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Vos, Dr AA and Groenewout, Dr M |
| Faculty: | Medical Sciences |
| Date Deposited: | 03 Apr 2026 13:26 |
| Last Modified: | 03 Apr 2026 13:26 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3915 |
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