Abstract

Caesarean section (CS) is the most common obstetric surgery. Despite improving facilities, it is still associated with risks and potential complications, often requiring relaparotomy. Aims & objectives : To identify the risk factors such as indication of relaparotomy, measures taken for management and to assess the maternal outcome in a tertiary care centre. Materials & methods : A prospective observational study, was conducted in the department of Obstetrics & Gynaecology, Nil Ratan Sircar Medical College & Hospital, Kolkata, from May’2015 to April’2016. Twenty-four women confined by CS and within 6 wks postpartum and required relaparotomy were included in our study. Demographic characteristics, indication for CS, indication for relaparotomy, operative findings, intervention, blood transfusion, ICU admission, maternal outcome noted. Using SPSS software statistical analysis was done. Results: A total of 24 women required relaparotomy. 66.6% had outside delivery and 87.5% had emergency CS. Previous CS (25%) & foetal distress (25%) were common indications for primary CS. Abdominal distension (75%) commonest presentation. Suspected intraperitoneal hemorrhage (58.3%), atonic PPH (12.5%), rectus sheath hematoma (12.5%) were the indications for relaparotomy. On relaparotomy 58.3% had hemoperitoneum, 25% had rectus sheath hematoma, 25% required hysterectomy. Almost every women required blood transfusion. 58.3% had uneventful recovery, 25% had secondary suturing. One death was there. Conclusion: The incidence of relaparotomy after CS is 0.19% in our hospital. Exposure to CS is itself definite risk factor with complication requiring relaparotomy. Therefore limiting the rate & cautious approach towards performing CS decreases the risk of relaparotomy.

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