An analysis of relaparotomy in operative obstetrics
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Relaparotomy in obstetrics following cesarean section or laparotomy is associated with high morbidity and mortality and hence, considered as a maternal near miss. The selection of patient for the same is crucial. This study was done to know the incidence, indications, the risk factors, intraoperative procedures, and mortality rates of relaparotomy.

During the study period 28 cases of relaparotomy were identified. The incidence of relaparotomy was 0.24%. Intraperitoneal hemorrhage (39.2%) was commonest indication of reoperations followed by PPH (17.8%), rectus sheath hematoma (14.8%), and burst abdomen (10.7%). Obstructed labor (32.1%) was the commonest indication of primary cesarean. Hysterectomy was required in 8 cases (25.7%), evacuation of blood for hemoperitoneum was required in another 8 cases. Most cases of hemorrhage were reopened within 24 hours, whereas the most cases of the rectus sheath hematoma, burst abdomen, and broad ligament hematoma were reopened between 5-9 days.

Relaparotomy is often a lifesaving procedure. The decision to perform and manage relaparotomy should always be done by senior obstetricians. Meticulous surgical techniques to secure hemostasis at the time of primary surgery should be adopted. Strict postoperative vigilance is of utmost importance for early detection of intraperitoneal hemorrhage and other complications requiring relaparotomy as a timely intervention.

Source: https://www.ijrcog.org/index.php/ijrcog/article/view/8417
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