title: The Robson ten-group classification system for appraising deliveries at a tertiary referral hospital in Brazil.
abstract: OBJECTIVE
  To evaluate the distribution of women according to the Robson 10-group classification system (RTGCS) and the occurrence of severe maternal morbidity (SMM) by mode of delivery at a tertiary referral hospital.
  
  
  METHODS
  A retrospective cross-sectional study was conducted of all women admitted to the Women's Hospital at the University of Campinas (Campinas, Brazil) for delivery between January 2009 and July 2013. Women were grouped according to RTGCS. Mode of delivery and SMM (defined as need for admission to the intensive care unit) were assessed.
  
  
  RESULTS
  Among 12 771 women, 5957 (46.6%) delivered by cesarean. Overall, 3594 (28.1%) women were in group 1 (nulliparous, single pregnancy, cephalic, term, spontaneous labor), 2328 (18.2%) in group 5 (≥1 previous cesarean, single pregnancy, cephalic, term), and 2112 (16.5%) in group 3 (multiparous excluding previous cesarean, single pregnancy, cephalic, term, spontaneous labor). Group 5 contributed the most cesarean deliveries (1626 [27.3%]), followed by group 2 (nulliparous, single pregnancy, cephalic, term, induced labor or cesarean before labor; 1049 [17.6%]). SMM was more common among women undergoing cesarean delivery than among those delivering vaginally in groups 1-5.
  
  
  CONCLUSIONS
  The RTGCS allowed the identification of groups with the highest frequency of cesarean delivery and an assessment of SMM. This should be considered in related health policies.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Elton C
authors.initials: EC
authors.lastname: Ferreira
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Rodolfo C
authors.initials: RC
authors.lastname: Pacagnella
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Costa
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil. Electronic address: cecatti@unicamp.br.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Cecatti
mesh_terms: D001938:Brazil; D002585:Cesarean Section / Q000009:adverse effects / Q000145:classification / Q000706:statistics & numerical data; D003422:Critical Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000145:classification* / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007745:Labor Onset; D007746:Labor Presentation; D010298:Parity; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D047929:Term Birth
keywords: Birth; Cesarean classification; Cesarean delivery; Severe maternal morbidity