Relaparotomy after Cesarean Section: Experience in a Tertiary Referral Hospital.

Abstract

This study was aimed at exploring the causes of relaparotomy following caesarean section. The surgical procedures performed during relaparotomy were also discussed. This was a prospective study conducted in the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2020 to May 2021. MMCH is the largest referral Hospital in Mymensingh. During this study period 48 puerpera needed relaparotomy after caesarean section within 6 weeks of caesarean section. The frequency of relaparotomy was 2.6%. Of the 48 cases, 28(58.33%) cases needed relaparotomy due to post partum haemorrhage (PPH). Among them 9(18.75%) had primary PPH, 19(39.58%) patients had secondary PPH. Here 7(14.58%) patients suffered from sub rectus hematoma, 5(10.42%) patients had puerperal sepsis, 3(6.23%) had internal haemorrhage and 4(8.33%) women had wound dehiscence. Foreign body was removed in 1 case (2.08%). Main procedure performed was subtotal (45.83%) and total hysterectomy (25%). Coagulation failure and septicaemia were causes of maternal death. Case fatality rate was 4.17%. Obstetric patients who need relaparotomy face potential death. This study will help us to identify the causes for relaparotomy. Due precautions should be taken as far as possible to avoid this complications following caesarean section and thereby reduce maternal mortality and morbidity.