Emergency cesarean section risk factors of Robson 1, 2A, 3, 4A Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Material and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.