{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T01:29:05Z","timestamp":1781918945171,"version":"3.54.5"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T00:00:00Z","timestamp":1544659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Cesarean section rates are increasing worldwide and Robson's classification system allows a practical approach to study this phenomenon. C\u2010section in Chile has been indicated as unexpectedly high, with important variability within the country and payment systems. The aim was to report our data using Robson's system and the evolution of local C\u2010section rate in a public hospital during a 9\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis (2005\u2013April 2014), in a metropolitan hospital in Santiago. All deliveries were classified into Robson groups. Time changes were analyzed with Pearson's correlation. <jats:italic>P<\/jats:italic> value &lt;0.05 was considered significant. A \u2018relevance index\u2019 (RI) for each group was calculated as 100 \u00d7 C\u2010S rate \u00d7 relative contribution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall C\u2010section rate increased from 24 to 27% (<jats:italic>P<\/jats:italic> &lt; 0.05) in 53 571 deliveries, with a greater increase in groups 1 (nulliparous, single, term cephalic, spontaneous labor), 3 (multiparous, single, no previous C\u2010S, term cephalic, spontaneous labor) and 4 (multiparous, single, no previous C\u2010S, term cephalic, induced or no labor). Despite no increase in Group 5 (women with one or more previous C\u2010S) this group had the highest RI (20.3), which defined priority for intervention over others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>C\u2010S rate was lower than that reported in other centers from Chile and Latin America. Robson's classification and the RI allowed prioritization. Although increase in groups 1, 3 and 4, group 5 needs attention because of stronger impact on overall C\u2010S rate. This analysis allowed to define how to lower C\u2010S rate in our institution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13879","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T04:52:58Z","timestamp":1544763178000},"page":"578-584","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cesarean rates in a Chilean public hospital and the use of a new prioritization criteria: The relevance index"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9910-105X","authenticated-orcid":false,"given":"Masami","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"},{"name":"Clinica Universidad de los Andes  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Latorre","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Rojas","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardita","family":"Walker","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Jord\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Carrillo","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Paiva","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Insunza","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado Faculta de Medicina Cl\u00ednica Alemana de Santiago\u2010Universidad del Desarrollo  Santiago, 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