{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:47:24Z","timestamp":1790048844286,"version":"4.0.1"},"reference-count":42,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Global cesarean section (CS) rates continue to rise, with the Robson classification widely used for analysis. However, Robson Group 2A patients (nulliparous women with induced labor) show disproportionately high CS rates that cannot be fully explained by demographic factors alone. This study explored how the Artificial Intelligence Dystocia Algorithm (AIDA) could enhance the Robson system by providing detailed information on geometric dystocia, thereby facilitating better understanding of factors contributing to CS and developing more targeted reduction strategies. The authors conducted a comprehensive literature review analyzing both classification systems across multiple databases and developed a theoretical framework for integration. AIDA categorized labor cases into five classes (0\u20134) by analyzing four key geometric parameters measured through intrapartum ultrasound: angle of progression (AoP), asynclitism degree (AD), head\u2013symphysis distance (HSD), and midline angle (MLA). Significant asynclitism (AD \u2265 7.0 mm) was strongly associated with CS regardless of other parameters, potentially explaining many \u201cfailure to progress\u201d cases in Robson Group 2A patients. The proposed integration created a combined classification providing both population-level and individual geometric risk assessment. The integration of AIDA with the Robson classification represented a potentially valuable advancement in CS risk assessment, combining population-level stratification with individual-level geometric assessment to enable more personalized obstetric care. Future validation studies across diverse settings are needed to establish clinical utility.<\/jats:p>","DOI":"10.3390\/jimaging11080276","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T11:31:37Z","timestamp":1755516697000},"page":"276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Contribution of AIDA (Artificial Intelligence Dystocia Algorithm) to Cesarean Section Within Robson Classification Group"],"prefix":"10.3390","volume":"11","author":[{"given":"Antonio","family":"Malvasi","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0606-6425","authenticated-orcid":false,"given":"Lorenzo E.","family":"Malgieri","sequence":"additional","affiliation":[{"name":"The New European Surgical Academy (NESA), 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1481-9506","authenticated-orcid":false,"given":"Michael","family":"Stark","sequence":"additional","affiliation":[{"name":"The New European Surgical Academy (NESA), 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Di Naro","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Farine","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON M5G 1Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5061-8007","authenticated-orcid":false,"given":"Giorgio Maria","family":"Baldini","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Dellino","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Yassa","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynecology, \u015eehit Prof. Dr. \u0130lhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, 34785 \u0130stanbul, Turkey"},{"name":"Clinic of Obstetrics and Gynecology, Kartal Ac\u0131badem Hospital, 34865 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8426-8490","authenticated-orcid":false,"given":"Andrea","family":"Tinelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino), \u201cVeris delli Ponti Hospital\u201d, 73020 Scorrano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9862-1619","authenticated-orcid":false,"given":"Antonella","family":"Vimercati","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9711-3497","authenticated-orcid":false,"given":"Tommaso","family":"Difonzo","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.31729\/jnma.7138","article-title":"Robson\u2019s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-Sectional Study","volume":"59","author":"Gautam","year":"2021","journal-title":"JNMA J. 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