{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:15:29Z","timestamp":1789380929776,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T00:00:00Z","timestamp":1415145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n \n Cesarean section (\n CS<\/jats:styled-content>\n ) rates have risen far in excess of the optimal 15% recommended by the World Health Organization. The\n R<\/jats:styled-content>\n obson\n T<\/jats:styled-content>\n en\n G<\/jats:styled-content>\n roup\n C<\/jats:styled-content>\n lassification\n S<\/jats:styled-content>\n ystem (\n TGCS<\/jats:styled-content>\n ) allows meaningful analysis of a\n CS<\/jats:styled-content>\n rate. The aim of this study is to identify the leading patient categories contributing to our institution's\n CS<\/jats:styled-content>\n rate.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Prospective study of all women who delivered at the\n S<\/jats:styled-content>\n ingapore General Hospital from\n J<\/jats:styled-content>\n anuary 2008 to\n D<\/jats:styled-content>\n ecember 2011. The following data was recorded: parity, singleton\/multiple pregnancy, previous\n CS<\/jats:styled-content>\n , mode of labor onset and gestational age at delivery.\n CS<\/jats:styled-content>\n rates were computed for each group, as well as their relative contribution to the overall\n CS<\/jats:styled-content>\n rate.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 6074 deliveries, in which 2011 (33.1%) women had\n CS<\/jats:styled-content>\n delivery. Group 5 was the largest contributor to the overall\n CS<\/jats:styled-content>\n rate (25.9%). Of the patients in this group, 18.8% had a successful vaginal birth after cesarean (\n VBAC<\/jats:styled-content>\n ). Group 2 was the second largest contributor to the overall\n CS<\/jats:styled-content>\n rate at 18.0%. Group 10 had a high contribution of 16.1%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The\n TGCS<\/jats:styled-content>\n allows easy identification of the leading contributing patient groups. The surprisingly high contribution of group 10 suggests that our institution, a tertiary multidisciplinary teaching hospital, manages a sizeable group of high\u2010risk patients in its obstetric case mix accounting for the high\n CS<\/jats:styled-content>\n rate. Almost one in five term pregnancies with one previous\n CS<\/jats:styled-content>\n had a successful vaginal delivery, suggesting that the institutional attempted\n VBAC<\/jats:styled-content>\n rate is higher than 20%.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jog.12608","type":"journal-article","created":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T05:43:31Z","timestamp":1415166211000},"page":"534-539","source":"Crossref","is-referenced-by-count":21,"title":["Rational dissection of a high institutional cesarean section rate: An analysis using the Robson Ten Group Classification System"],"prefix":"10.1111","volume":"41","author":[{"given":"Jarrod KH","family":"Tan","sequence":"first","affiliation":[{"name":"Deparment of Obstetrics and Gynaecology Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng Loy","family":"Tan","sequence":"additional","affiliation":[{"name":"Deparment of Obstetrics and Gynaecology Singapore General 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