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Risk factors for relaparotomy after a cesarean delivery: a case-control study
Uri Amikam1,2, Yael Botkovsky3, Alyssa Hochberg3,4
1Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, 6 Weizmann St, Tel Aviv, Israel. uriamikam@gmail.com.
BMC Pregnancy and Childbirth
|April 17, 2024
Summary
Relaparotomy after cesarean delivery (CD) is rare but linked to factors like uterine anomalies, multiple pregnancies, and delivery complications. Identifying these risks can help reduce maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Surgical Outcomes Research
Background:
- Relaparotomy following cesarean delivery (CD) is an infrequent complication with unclear risk factors and indications.
- This study aimed to identify specific risk factors and indications for relaparotomy post-CD.
Purpose of the Study:
- To determine risk factors and indications for relaparotomy after cesarean delivery (CD).
Main Methods:
- A retrospective case-control study was conducted from 2013-2023 at a single tertiary center.
- 130 patients undergoing relaparotomy post-CD were compared to a 1:2 control group.
- Logistic regression analysis was used to identify significant risk factors, adjusting for confounders.
Main Results:
- Relaparotomy occurred in 0.46% of 28,280 cesarean deliveries.
- Significant risk factors included Mullerian anomalies, uterine fibroids, multiple pregnancy, hypertensive disorders, CD during the second stage of labor, CD complications, and excessive bleeding.
- Suspected intra-abdominal bleeding was the primary indication for relaparotomy within the first 24 hours.
Conclusions:
- Several pregnancy, intrapartum, and intra-operative factors are associated with the need for relaparotomy after CD.
- Identifying at-risk patients can potentially reduce associated maternal morbidity.
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