Technical Update No. 436: Classification of Cesarean Deliveries in Canada: The Modified Robson Criteria.

Objective: To describe and advocate for the use of a common classification system for cesarean delivery in Canada.

Target Population: Pregnant individuals undergoing cesarean delivery.

Benefits, Harms, Costs: Use of a standardized classification system for cesarean delivery allows for local, regional, national, and international comparison of cesarean delivery rates and trends. The system is inclusive and simple to implement, based on existing databases.

Evidence: A comprehensive literature review was updated to April 2022 with medical subject headings (MeSH) and keywords (cesarean section, classification, taxonomy, nomenclature, terminology) in MEDLINE/PubMed and Embase databases. Results were restricted to systematic reviews, randomized controlled trials and clinical trials, and observational studies. Additional literature was identified by backward citation tracking using relevant full-text articles. The grey literature was reviewed by searching websites of health agencies.

Validation Methods: The authors rated the quality of evidence and strength of recommendation using the Grade of Recommendations, Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretation of strong and conditional [weak] recommendations).The Board of the SOGC approved the final draft for publication.

Intended Audience: Obstetric care providers, health care administrators, epidemiologists.