Hypertensive disorders of pregnancy as determinant of caesarean delivery in Robson group 10.

Background and purpose of the study

Hypertensive disorders of pregnancy (HDP) constitute one of the leading causes of maternal and perinatal mortality worldwide. The mode of delivery in women with HDP should be guided by routine obstetric indications. Vaginal delivery is preferred for gestational hypertension or preeclampsia without severe features.Though vaginal delivery is achieved in most cases of HDP, but in preeclampsia with severe features ,vaginal delivery is often not accomplished as the gestational age decreases.The occurrence of delivery by caesarean section at less than 28 weeks of gestation may go upto 97%, and between 28–32 weeks of gestation, it goes upto 65% as per the existing literature. The decision to perform cesarean delivery should be individualized. Although the decision of pregnancy termination in HDP is guided primarily by maternal status, maturity of fetus and risks associated with preterm Caesarean section (CS) should also be kept in mind.

Rising Cesarean section (CS) rates is now a global concern. Out of the 10 classes of Robson Ten group classification system, the most common contributor to Caesarean section is Robson group 5, followed by group 2 and group 1. The fourth contributory group is group 10 which refers to single, cephalic, less than 37 weeks of gestation(preterm). The decision of mode of delivery in preterm antenatal women is very prudent keeping in view its impact on the subsequent pregnancy outcome. Thus Robson group 10 needs to be scrutinized for the indications of caesarean delivery.

With this background, the present thesis has been aimed to study Hypertensive disorders of pregnancy as determinant of Caesarean Section in Robson group 10.