Incidence and causes of relaparotomy after an obstetric and gynaecological operation

Abstract

Background: The causes for a reoperation include abdominal haemorrhage, internal bleeding, postpartum haemorrhage, rectus sheath hematoma, sepsis etc. This study was conducted to identify the cause for reoperations in our area. Methods: This retrospective study was undertaken over a Two Years period in our hospital on 1982 patients underwent primary obstetric and gynecological surgeries out of which 15 required a resurgery. 21 cases were referred to our hospital from outside. Detailed history of the women, parity, age, clinical history, procedure of the previous surgery, hospital stay, details of any complications and discharge summary were considered. Indications of relaparotomy were also analyzed. Results: The incidence of a relaparotomy of the surgeries performed at our hospital was 0.76%. The most common age group was 20-35 years. The most common indication for resurgery was intra peritoneal hemorrhage which accounted for 20 (55.6%) of the cases followed by rectus sheath hematoma in 9 (25%) and sepsis (11.1%). Drainage and suturing was the most common procedure performed during the relaparotomy. 5 cases underwent complete hysterectomy. Conclusions: Relaparotomy is a rare condition which is required in 7 out of 1000 primary surgeries. Care, if taken to maintain homeostasis during the primary surgery, may reduce the need for a resurgery.