Risk factors for relaparotomy after cesarean section

Objective: To investigate risk factors for relaparotomy after cesarean section (CS). Methods: A retrospective case-control study comparing all CS that were complicated with relaparotomy to cesarean deliveries without this complication. Results: Relaparotomy complicated 0.23% (n80) of CS during the study period (n34,389). Independent risk factors for relaparotomy following CS from a multivariable logistic regression model were post partum hemorrhage, cervical tears, placenta previa, uterine rupture, placental abruption, severe preeclampsia and previous CS. Most women (51.2%) underwent relaparotomy during the first 24h after CS. The leading causes for relaparotomy was bleeding (70%) and burst abdomen (8.8%). Hysterectomy was performed in 31.3% of the patients. Conclusion: Risk factors for relaparotomy after CS are previous CS, severe preeclampsia, placenta previa, uterine rupture, placental abruption, cervical tear and PPH. Experienced obstetricians should be involved in such cases and the possibility for complications including relaparotomy should be emphasized.