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Return to the Operation Theatre: An Analysis of Repeat Surgeries in Operative Obstetrics

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Abstract

Purpose

To determine the risk factors and associated comorbidities with a relaparotomy after primary surgery in pregnant mothers and to identify preventable causes.

Methods

A retrospective observational study was done at a tertiary care centre from January 2009 till August 2014. All records of exploratory laparotomy following primary surgery in the obstetric population during this period were retrieved from the hospital database and analysed.

Results

The incidence of relaparotomy was 0.22 %. In 94 % cases, the primary surgery was caesarean section. The commonest indication for relaparotomy was due to haemorrhagic complications like bleeding and haematoma (66.8 %). Sepsis was seen in 36.1 % cases with the predominant organism isolated being E coli (54 %). Most common comorbidity was hypertensive disorders (58 %) followed by liver disorders (19 %). 33.3 % needed ventilatory support, 30.5 % needed massive blood transfusion, 16.6 % were on total parenteral nutrition and 2.7 % needed renal replacement therapy. Maternal mortality was 2.8 %.

Conclusion

Relaparotomy following caesarean section is considered a near-miss mortality. Care must be taken in primary surgery with meticulous attention to haemostasis. Strict postoperative vigilance must be adhered to for timely detection of complications and appropriate intervention.

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Authors and Affiliations

  1. Fernandez Hospital, Hyderabad, India

    Maimoona Ahmed, Sunil T. Pandya & Tarakeswari Supraneni

Authors
  1. Maimoona Ahmed
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  2. Sunil T. Pandya
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  3. Tarakeswari Supraneni
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Corresponding author

Correspondence to Maimoona Ahmed.

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Conflict of interest

The authors declare no conflict of interest.

Human Rights and Ethical Statements

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

All registrants at the study hospital provide informed consent as a routine for the use of their data for academic and research purposes.

Additional information

Dr. Maimoona Ahmed, MS, is a Fellow in High Risk Pregnancy and Perinatology at Fernandez Hospital, Hyderabad, India; Dr. Sunil T. Pandya, MD, is Head of Department of Anaesthesia, Pain and Critical Care at Fernandez Hospital, Hyderabad; Dr. Tarakeswari Supraneni, MD, Head of Department, High Risk Pregnancy at Fernandez Hospital, Hyderabad.

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Ahmed, M., Pandya, S.T. & Supraneni, T. Return to the Operation Theatre: An Analysis of Repeat Surgeries in Operative Obstetrics. J Obstet Gynecol India 66 (Suppl 1), 117–121 (2016). https://doi.org/10.1007/s13224-015-0815-5

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  • DOI: https://doi.org/10.1007/s13224-015-0815-5

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