Classification of caesarean sections in Canada: the Modified Robson criteria.

OBJECTIVE: To advocate for the use of a common classification system for Caesarean section across Canada. OPTIONS: A variety of clinical parameters for classification were considered. OUTCOMES: Consideration of a common system for classifying Caesarean section. EVIDENCE: Studies published in English from 1976 to December 2011 were retrieved through searches of Medline and PubMed, using appropriate controlled vocabulary and key words (Caesarean section, vaginal birth after Caesarean, classification). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified through searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and the web sites of national and international medical specialty societies. VALUES: The studies reviewed were classified according to criteria described by the Canadian Task Force on Preventive Health Care, and the recommendation for practice ranked according to this classification (Table 1). SPONSORS: The Society of Obstetricians and Gynaecologists of Canada. Recommendation Modified Robson criteria should be used to enable comparison of Caesarean section rates and indications. (III-B).