European Journal of Molecular & Clinical Medicine

Objective: To analyse rising rates of caesarean section, its indications and effect on maternal and neonatal outcomes viz a viz vaginal deliveries with special focus on primary caesarean section.
Study design: This was a prospective observational study of 1000 deliveries after 28 weeks’ gestation. The different modes of deliveries were studied with respect to their antepartum, intrapartum and postpartum feto-maternal outcomes. A comparative analysis of caesarean and vaginal deliveries was carried out with particular focus on primary caesarean sections.
Results: The caesarean section rate was 47.1% out of which 66.2% were primary caesarean sections(PCS). The most common indication of PCS was found to be foetal distress (34.2%) and blood loss, febrile morbidity, SSI were more in caesarean sections compared to vaginal deliveries (VD). Neonatal outcomes too were relatively worse in caesarean sections compared to VD.
Conclusion: There has been an unacceptably high rise in caesarean section rates globally. It has been accepted that maternal and neonatal outcomes remain comparatively favourable with vaginal deliveries. Hence there is a need to have a closer look at the various indications of caesarean deliveries with regular caesarean audits at all levels of health care with a targeted focus on PCS, which is the genesis of the rising rates. CS should be resorted to only when there is an evidence based indication with the aim of improving the reproductive years of the mother and future development of the newborn.

Background: Relaparotomy (RELAP) after caesarean section is a serious complication and is associated with maternal morbidity and mortality. The data of re-laparotomy after caesarean section is limited. So in the present study, we will evaluate the risk factors and outcome of relaparotomy after cesarean section in our study population.
Objective: To identify the risk factors and complications and outcomes associated with re- laparotomy after caesarean section.
Materials and Methods: It is a retrospective study, a total of 16 relaparotomy cases were included in this study. Data such as age, parity, period of gestation, comorbidities, indication for C-section and relaparotomy, a procedure during relaparotomy and the interval between two surgeries are recorded. Using SPSS software statistical analysis is done.
Results: Incidence of re-laparotomy is found to be 0.25% and the mean age was found to be 25.5±4.2 years with 37.5% primigravidae. The Major indication for C-section and Relaparotomy was Placenta previa (37.5%) and hemoperitoneum (37.5%). The mean time interval between C-section and relaparotomy was 6.8 ± 1.2 days and the major procedure done during relaparotomy is tension suture (31.25%). The rate of recovery and maternal death was found to be 93.8% and 6.3% respectively.
Conclusion: Caesarian section will be done due to clinical complications in delivery. After C-section, women are treated conservatively, but in some cases, there is a need for relaparotomy. It will be performed when the patient’s condition is too critical. Relaparotomy is a life-saving procedure to save the life of patients. Proper care should be taken during primary and secondary surgery to prevent postoperative infection and other complications which will decrease the clinical complication and mortality rate.