Relaparotomy following cesarean section - a single center study

Relaparotomy is a serious complication of caesarean section. The aim of this study was to investigate its risk factors and postoperative outcome.

We conducted a retrospective case-control study examining 48 reoperations between January 2013 and June 2017 at the Obstetrics and Perinatology Department, Jagiellonian University Hospital in Cracow, Poland. This is tertiary referral center, in that time 8421 cesarean section were performed. The control group was randomly matched from all CS in a 1 to 2 ratio. The following figures were analyzed: demographic obstetrics data, indication for cesarean section, perioperative data and laboratory results. Patients' follow up data was evaluated.

The frequency of relaparotomy was 0.57%. There were no statistically significant differences in indications for primary surgery between the control group and the relaparotomy group. There were only two perioperative factors which increased the risk of relaparotomy: general anesthesia and the duration of operation. Laboratory results were in reference range in both groups, however, in the relaparotomy group, platelets were lower, while APTT and INR were prolonged. The main indication for relaparotomy was bleeding into the peritoneal cavity. Patients with relaparotomy more often required blood transfusion, admission to ICU, as well as longer hospitalization.

Recognition of risk factors of relaparotomy and proper diligence in hemostasis may decrease its rate.