Outcome of Relaparotomy in Gynae and Obstetrics cases in DMCH

Abstract

Background: Relaparotomy is a laparotomy performed within 60 days of the initial surgery. Relaparotomy is a major problem for surgeons and patients as they experience second surgery within a short time period.  It challenges the physical and mental endurance of patients. Objectives: The study objective is to find out the indications and risk factors of relaparotomy in gynae and obstetrics cases in DMCH. Methods: A descriptive cross-sectional study was conducted on 30 patients who met the inclusion criteria and were admitted to the Department of Gynecology and Obstetrics, Dhaka Medical College Hospital between July 2017 to December 2017. Purposive sampling technique was used and data were collected through medical records and interviewing the patients. Data were analyzed using SPSS (Statistical Package for Social Science) version 21. Ethical approval was taken by the ethical committee of the DMCH and written consent was taken from the concerned authority and the patients. Results: Incidence of relaparotomy in Dhaka Medical College & Hospital was 0.95%. Most of the (56.67%) patients were in between 20- 30 years, most of the (80%) patients were house wife. Most of the patients were from rural area (50%). Seventeen patients (57.67%) did not require blood transfusions, while 43.33 % required blood products peri-operatively or postoperatively. Deaths occurred at a rate of 6.66%. Hemorrhagic shock (3.33%) and septicemia with hemorrhagic shock (3.33%) were the leading causes of death. Conclusion: Relaparotomy is a life-saving operation after unsuccessful primary laparotomy. However, serious complications might arise from cesarean birth, demanding extra surgery for patients. This includes performing routine caesarean sections as well as dealing with any difficulties that emerge during or after the procedure.