Abstract :
Objective: To identify the risk factors and complications associated with re-laparotomy after obstetric
surgeries in NRI Medical College & General Hospital (NRIGH), Chinnakani, Guntur District.
Materials and Methods: Cross sectional study including twelve women that underwent re-laparotomy
after obstetric surgeries in NRIGH, Chinnakani, Guntur District, Andhra Pradesh during the period from
January 2016 to January 2018 whether the primary operation was done at our hospital or patients were
referred from other hospitals or private centres to our tertiary care centre.
Results: Incidence of relaparotomy was 0.77 % (12/1549). Haemorrhage was the most common indication
for re-laparotomy (58%). The second most common indication was intra-peritoneal collection in 16 %
of cases. Six cases were haemodynamically unstable at the time of re-laparotomy (50 %) and seven cases
(58%) were admitted to ICU postoperatively. The main surgical procedure performed during re-laparotomy
was hysterectomy (7 cases). The most common complication was massive blood transfusion. Maternal
mortality occurred in three cases (25%). The cause for maternal deaths was multiple organ failure in one
case, disseminated intravascular coagulopathy (DIC) in two cases.
Conclusion: Re-laparotomy is associated with high maternal morbidity and mortality. Emergency
relaparotomy is a life -saving procedure. Good expertise during primary surgery and right surgical
technique, maintaining intr a operative hemostasis, prevention of postoperative infection can avoid
relaparotomy.
Keyword :
Relaparotomy, Caesarean section, Hemorrhage, Hysterectomy, Meticulous Haemostasis.