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A method to assess obstetric outcomes using the 10-Group Classification System: a quantitative descriptive study
  1. Janne Rossen1,2,
  2. Miha Lucovnik3,
  3. Torbjørn Moe Eggebø2,4,5,
  4. Natasa Tul3,
  5. Martina Murphy6,
  6. Ingvild Vistad1,
  7. Michael Robson6
  1. 1 Department of Obstetrics and Gynecology, Sørlandet Hospital HF Kristiansand, Kristiansand, Norway
  2. 2 Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
  3. 3 Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
  4. 4 Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
  5. 5 National Center for Fetal Medicine, Trondheim University Hospital, St Olavs Hospital, Trondheim, Norway
  6. 6 National Maternity Hospital, Dublin, Ireland
  1. Correspondence to Dr Janne Rossen; janne.rossen{at}


Objectives Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information.

Design This research is a methodological study to describe the use of the TGCS.

Setting Stavanger University Hospital (SUH), Norway, National Maternity Hospital Dublin, Ireland and Slovenian National Perinatal Database (SLO), Slovenia.

Participants 9848 women from SUH, Norway, 9250 women from National Maternity Hospital Dublin, Ireland and 106 167 women, from SLO, Slovenia.

Main outcome measures All women were classified according to the TGCS within which caesarean section, oxytocin augmentation, epidural analgesia, operative vaginal deliveries, episiotomy, sphincter rupture, postpartum haemorrhage, blood transfusion, maternal age >35 years, body mass index >30, Apgar score, umbilical cord pH, hypoxic–ischaemic encephalopathy, antepartum and perinatal deaths were incorporated.

Results There were significant differences in the sizes of the groups of women and the incidences of events and outcomes within the TGCS between the three perinatal databases.

Conclusions The TGCS is a standardised objective classification system where events and outcomes of labour and delivery can be incorporated. Obstetric core events and outcomes should be agreed and defined to set standards of care. This method provides continuous and available observations from delivery wards, possibly used for further interpretation, questions and international comparisons. The definition of quality may vary in different units and can only be ascertained when all the necessary information is available and considered together.

  • Caesareansection
  • quality of care
  • labouroutcome
  • neonatal outcome
  • the 10-Group Classification System
  • core outcome

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors JR, ML, TME and MR contributed to the idea and design of the study. JR, ML, NT, MM and TME contributed to the preparation of the data used. JR, TME, IV and MR assisted in the literature research and editing of the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have no financial and material support to report.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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