Gynecology & Obstetrics
Open Access

Abstract

Re-Laparotomy after Caesarean Section at a Tertiary Hospital in Egypt: Cross Sectional Study

Reham Elkhateeb, Ahmad Ezz El-Din Mahran, Ahmad Samir Sanad and Haitham Ahmad Bahaa

Objective: To identify the risk factors and complications associated with re-laparotomy after caesarean section (CS) at Mina Maternity university Hospital in Egypt.

Methods: Cross sectional study including thirty two women that underwent re-laparotomy after CS at Minia Maternity university Hospital during the period from April 2015 and March 2016 whether the primary operation was done at the hospital or patients were referred from other hospitals or private centres.

Results: Repeated Cs was the most common indication for CS followed by re-laparotomy (37.5%). The second most common indication was morbidly adherent placenta (MAP) (15.6%). Intra-peritoneal collection was the indication for re-laparotomy in 50% of cases. CS was done by junior obstetricians in 56.3%, of cases. Fifteen cases were haemodynamically unstable at the time of re-laparotomy (46.9%) and 20 cases (62.5%) were admitted to ICU postoperatively. The main surgical procedure performed during re-laparotomy was hysterectomy (15 cases). The most common complication was massive blood transfusion. Maternal mortality occurs in eight cases (25%). The cause for maternal deaths was irreversible shock in four cases, multiple organ failure in two cases, disseminated intravascular coagulopathy (DIC) in one case and sepsis in one case.

Conclusion: Re-laparotomy after CS is associated with high maternal morbidity and mortality. Efforts should be directed to reduce the rate of CS as repeated CS was identified as the main indication for CS followed by relaparotomy.