Risk Factors, Indications and Outcome among Relaparotomy following Caesarean Section cases in BSMC & H, Bankura, WB

Abstract

Objectives: The objective of the present study was to study about the risk factors, indications and outcome among relaparotomy following the caesarian section.Methods:A retrospective observational study was conducted in a Bankura Sammilani Medical College and Hospital in Bankura, West Bengal, India from September 1, 2018 to August 31, 2020 of the thirty seven cases that required relaparotomy following caesarean section.Result: During this two year time frame, a total of 22,192 cesarean deliveries was performed out of 46,214 live birth, among which total of 37 cases had relaparotomy. All the relaparatomy cases were following emergency caesarian section. The most dominant indication of caesarian section was non-progress of labour (21.62%) and post CS scar tenderness (35.13%). Regarding the indication of relaparatomy, most of the cases due to rectus sheathe hematoma (RSH) (29.72%) and intra-peritoneal hemorrhage (27.02%). Ligation of bleeding point (64.86%) and hysterectomy (18.91%) were done in most of the cases.In postoperative complications, out of 37 relaparatomy cases, maternal death occur in 2 cases (5.40%) and in 91.89% cases, patient was discharged at stable condition.Conclusion: Relaparatomy after caesarian section is life saving process. It is the main challenge to take decision to go for early reoperation following caesarian section. The interval between initial operation and relaparotomy, indications of caesarian section, post-operative condition and intra-operative findings are the utmost important parameters that determine the outcome. Proper diagnosis, emergency condition of patient, use of meticulous surgery techniques can minimize the risk of relaparatomy.