title: Robson Ten Group Classification System applied to women with severe maternal morbidity.
abstract: OBJECTIVE
  To evaluate the distribution of women with severe maternal morbidity according to Robson Ten Group Classification System (RTGCS).
  
  
  METHODS
  Secondary analysis of a multicenter cross-sectional study in 27 obstetric units in Brazil, using RTGCS. Cases were classified into potentially life-threatening condition or a maternal near miss or death, according to severity. Certain groups were subdivided for further analysis. Cesarean delivery (CD) rates were reported.
  
  
  RESULTS
  Among 7,247 women with severe maternal morbidity, 73.2 percent underwent CD. Group 10 (single, cephalic, preterm) was the most prevalent (33.9%). Groups mostly associated with a severe maternal outcome were: 7 (multiparous, breech), 9 (all abnormal lies, single, term), 8 (all multiple), and 10. Groups 1 (nulliparous, single, cephalic, term, spontaneous) and 3 (multiparous, single, cephalic, term, spontaneous) were associated with better maternal outcome. Group 3 had one severe maternal morbidity to 29 cases of potentially life-threatening, but the ratio was 1:10 for women undergoing CD, indicating a worse outcome. Group 4a (multiparous, no previous CD, single, cephalic, term, induced labor) had a better maternal outcome than those delivered by CD before labor (group 4b). Hypertension was the most common condition of severity.
  
  
  CONCLUSIONS
  The RTGCS was useful to consider severe maternal morbidity, showing groups with higher CD rates and worse maternal outcomes.
authors: Department of Obstetrics and Gynecology, School of Medicine at the University of Campinas, Campinas, Brazil.
authors: Elton Carlos
authors: EC
authors: Ferreira
authors: Maria Laura
authors: ML
authors: Costa
authors: José Guilherme
authors: JG
authors: Cecatti
authors: Samira M
authors: SM
authors: Haddad
authors: Mary Angela
authors: MA
authors: Parpinelli
authors: Michael S
authors: MS
authors: Robson
mesh_terms: D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification* / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D012720:Severity of Illness Index
keywords: cesarean delivery; classification of cesarean delivery; maternal near miss; severe maternal morbidity