Relaparotomy after caesarean section: a retrospective observational study in a tertiary medical college
Keywords:Caesarean section, Intraperitoneal haemorrhage, Pre-eclampsia, Postpartum haemorrhage, Rectus sheath hematoma
Background: Relaparotomy is the term which defines operations performed within 60days after the initial surgery. Ralaparotomy following caesarean section may happen and that’s why a study was done to evaluate the risk factors, indications, procedures done during relaparotomy after caesarean section.
Methods: A retrospective observational study was conducted in the department of obstetrics and gynaecology in burdwan medical college and hospital for a period of 3years from 1June 2019 to 31 May 2022. Total 32 cases required relaparotomy following caesarean section.
Results: In this study, there were 25,527 caesarean deliveries out of 56,145 total deliveries over 3years time period. Among caesarean deliveries 32 cases underwent relaparotomy (0.12%). In most of the cases relaparotomies were due to intraperitoneal haemorrhage, rectus sheath hematoma, postpartum haemorrhage. Indications of cesarean section were severe preeclampsia, non-progress of labour, abruption, post cesarean section with scar tenderness, meconium-stained liquor with fetal distress. Most of the women were in the age group of 20-30 years. Resuturing of the bleeding points were done in most of the cases.
Conclusions: As a lifesaving procedure, decision of relaparotomy should be taken as soon as possible. Proper hemostasis need to be ensured before closure of abdomen, as intraperitoneal haemorrhage is the most common indications for relaparotomy.
Levin I, Rapaport AS, Satzor L, Maslovitz S, Lessing JB, Along B. Risk factors for relaparotomy after caesarean delivery. Int J Gynaecol Obstet. 2012;119: 163-5.
Khan ANB. Relaparotomy after caesarean section:an analysis of the risk factors, indications and outcome Int J Reprod Contracept Obstet Gynecol. 2015;4(3):575-80.
Raagab AE, Misbah YH, Brabat RI, Zayed AA, Alsaammani MA. Relaparotomy after caesarean section: risks, indications and management options. Med Arch. 2014;68:44-5.
Unalp HR, Kamer E, Kar H. Urgent abdominal reexplorations. World J Emerg Surg. 2006;1:10.
Gedikbasi A, Akyol A, Asar E, Bingol B, Uncu R, Sargin A, et al. Re-laparotomy after caesarean section:operative complications in surgical delivery. Arch Gynecol Obstet. 2008;278(5):419-25.
Biswas SP, Halder S, Shirin FB. Indications and outcome of relaparotomy after caesarean section. Bang Med J. 2012;45:19-23
Kessous R, Donor D,Weintraub A, Wiznitzer A, Sergienko R, Ohel I, et al. Risk factors for relaparotomy after caesarean section. J Maternal-Fetal Neonatal Med. 2012;25:2167-70.
Seal SL, Kamilya G, Bhattacharyya SK, Mukherji J, Bhattarcharyya AR. Relaparotomy after caesarean delivery:experience from an Indian teaching hospital. J Obstet Gynaecol Res. 2007;33(6):804-9.
Shyamal D, Pratim SP, Aradhana K, Partha M, Kirti M, Subhankar D. Early re-operations after gynecological and obstetrical surgery- a five years. J Obstet Gynecol India. 2010;60:507-10.
Khan ANB, Kolasseri SS. Re-laparotomy after caesarean section: an analysis of the risk factors, indications and outcome. Int J Reprod Contracept Obstet Gynecol. 2015;4:575-80.
Rouf S, Sharmin S, Dewan F. Re-laparotomy after caesarean section:experience from a tertiary referral and teaching hospital of Bangladesh. Bangladesh J Obstet Gynaecol. 2009;24(1):3-9.
Ahmed M, Pandya ST, Supraneni T. Return to the operation theatre: an analysis of repeat surgeries in operative obstetrics. J Obstet Gynaecol India. 2016;66(1):117-21.