Article titled “Using Robson’s Ten-Group Classification System for comparing caesarean section rates in Europe: an analysis of routine data from the Euro-Peristat study” has wonderfully addressed the issues related to a system which has been introduced for almost twenty years.1For RTGC system, to truly become a guide to reduce the caesarean section rate, it’s all ten parameters in all cases should be available. Missing data and misclassification has been rightly highlighted by the authors.I have come across an article the authors of which had been my close colleagues.2 These authors analysed their operation theatre (OT) registers for its adequacy in providing data for RTGC of caesarean sections. Their observations indicate that on many heads the data is missing at both their institutions although with different rates. The authors recommend that the OT registers need to be modified to accommodate columns which would include all ten groups required for Robson’s classification system. Where printing new registers cannot be done immediately a rubber stamp is suggested which would immediately enable OT registers RTGC friendly. Same can be done for labour room (LR) registers for institutions which consider RTGC system as a perinatal classification system than just caesarean section classification3. At institutions which have system of digital data entry the software can be immediately updated to make the system RTGC friendly. The authors belong to developing nation where entry into registers is a more uniform system than digitalized system. Therefore authors advice incorporation of 8 columns (may be in an abbreviated form) under which just a mark or mark will complete the entry. In a rubber stamp impression authors suggest 14 portions. Just striking out which is not applicable will complete the entry required for RTGC.Another issue which needs to be addressed as regards implementation of RTGC system is misclassification due to un-standardized definitions of ten parameters (variables) of RTGC system. In this direction a RTGC system sensitization program needs to be undertaken for hospital staff (obstetricians, residents, nurses, data entry personnel) where definitions of core variables are discussed out as finalized by the hospital research committee and subsequently should become an essential component of orientation program for residents and obstetrics related staff. This would solve the issue of ‘known-knowns and unknown-unknowns’.3References:1. Zeitlin, J, Durox, M, Macfarlane, A, Alexander, S, Heller, G, Loghi, M, Nijhuis, J, Sól Ólafsdóttir, H, Mierzejewska, E, Gissler, M, Blondel, B; the Euro-Peristat Network. Using Robson’s Ten Group Classification System for comparing caesarean section rates in Europe: an analysis of routine data from the Euro-Peristat study. BJOG 2021; 128: 1444– 1453.2. Abdul Aziz, Fasiha T.; Bhoosreddy, Sushma R.. Robson ten groups classification system for caesarean section audit: are our operation theatre registers RTGC enabled? IJRCOG 2019, 8 (9): 3675-3678. doi:http://dx.doi.org/10.18203/2320-1770.ijrcog20193796.3. Robson, M.S. (2021), Known knowns, unknown unknowns and everything in-between – the Ten Group Classification System (TGCS). BJOG: Int J Obstet Gy, 128: 1454-1455. https://doi.org/10.1111/1471-0528.16679.