Relaparotomy after Cesarean Section: Experience in a Tertiary Referral Hospital

Area of Science:

• Obstetrics and Gynecology
• Surgical Outcomes
• Maternal Health

Background:

• Relaparotomy following cesarean section is a significant concern in obstetric care.
• Understanding the indications for and outcomes of relaparotomy is essential for improving patient safety.

Purpose of the Study:

• To explore the primary causes of relaparotomy after cesarean section.
• To document the surgical procedures performed during relaparotomy.
• To identify factors contributing to maternal mortality and morbidity in these cases.

Main Methods:

• A prospective study was conducted at Mymensingh Medical College Hospital, Bangladesh.
• Data were collected from November 2020 to May 2021.
• 48 patients requiring relaparotomy within six weeks of cesarean section were analyzed.

Main Results:

• The overall frequency of relaparotomy was 2.6%.
• Postpartum hemorrhage (PPH) was the most common indication (58.33%), including primary and secondary PPH.
• Other causes included sub-rectus hematoma (14.58%), puerperal sepsis (10.42%), internal hemorrhage (6.23%), and wound dehiscence (8.33%).
• Subtotal and total hysterectomies were the main surgical procedures performed.
• Maternal deaths were attributed to coagulation failure and septicemia, with a case fatality rate of 4.17%.

Conclusions:

• Postpartum hemorrhage is the predominant cause necessitating relaparotomy after cesarean delivery.
• Relaparotomy carries a significant risk of maternal mortality and morbidity.
• Implementing preventive measures and timely interventions can help reduce complications and improve outcomes.