Relaparotomy after Caesarean Section - An ObstetricianÃ¢??s Ordeal
BACKGROUND The term "Relaparotomy" (RL) refers to operations performed within 60 days in association with the initial surgery. The aim of current study was to investigate the indications, risk factors, procedures undertaken during relaparotomy after caesarean section (CS). METHODS We conducted a retrospective observational study in all patients undergoing relaparotomy after caesarean section, at a tertiary care centre in Odisha over a period of 2 years from January 2017 to December 2018. RESULTS The total incidence of relaparotomies was 0.7 % and the incidence among the sections conducted in our hospital alone was 0.2 %. Obstructed labour (20 %), oligohydramnios with fetal distress (20 %) are major indications of caesarean section. Most of the surgeries (60 %) took place within the first 24 hours of the primary surgery. Most common indication of relaparotomy in our study was postpartum haemorrhage (63.3 %). All women were in the age group of 20 - 35 years and most of them were multiparous (60 %). Pre-existing anaemia is the major (50 %) comorbid factor associated with atonic postpartum haemorrhage which leads to relaparotomy. Major indication of relaparotomy in the present study was haemorrhage (76.5 %). CONCLUSIONS Undertaking proper precautions to ensure proper haemostasis and asepsis, taking calculative decision before embarking a hasty decision is important in decreasing the incidence of relaparotomy.