Relaprotomy after caesarean section: An event of near miss maternal mortality.


  • Maimoona Qadir Khyber Teaching Hospital.
  • Jamila M.Naib Khyber Teaching Hospital.
  • Sadia Nasir Khyber Teaching Hospital.



Caesarean Section, Obstructed Labor, Placental Abruption, Placenta Previa, Postpartum Haemmorhage, Relaprotomy


Objective: To find out risk factors, indications, causes, maternal mortality and morbidity after relaprotomy following caesarean section. Study Design: Descriptive (Cross Sectional) study. Setting: Department of Gynae, Mardan Medical Complex. Period: March 2015 to February 2020. Material & Methods: All women of any age or parity who had undergone caesarean section for any indication, which was followed by a relaprotomy, within a 60 days time period, irrespective of the location of the primary surgery, was included. Decision for relaprotomy was taken by the consultant in charge. All the data was entered in a predesigned proforma. Results: The rate of relaprotomy was 0.25%. Majority (88%) was in 20-35 years age group. 16 (61%)  Patients were multigravidas and 8(31%) were primigravidas. Most (84.6%) of the cases were unbooked. 8(31%) patients were referred from remote areas and private centres, where caesareans had already taken place. Placental abruption was the most common indication (34.6%), followed by previous scars (19%) and placenta previa (15%). Mean interval between primary surgery and relaprotomy was 13.5 + 3.2 hours. Indication for relaprotomy was Postpartum and intraperitoneal haemmorhage in 34.6% cases each followed by rectus sheath and broad ligament hematoma in 7.7% cases each.84.6% patients were admitted in ICU, 65.4% received massive blood transfusions, whereas 30.7% developed DIC and febrile morbidity and renal impairment was seen in 19% cases. The mortality rate was 15.38% and all of them were referred cases. Conclusion: Relaprotomy after caesarean section is a very high risk situation. Postoperative vigilance, timely intervention and efficient referral system can reduce both maternal mortality and morbidity.

Author Biographies

Maimoona Qadir, Khyber Teaching Hospital.

MBBS, FCPS, Assistant Professor Obs & Gynae, 

Jamila M.Naib, Khyber Teaching Hospital.

MBBS, FCPS, Professor and Incharge Obs & Gynae, 

Sadia Nasir, Khyber Teaching Hospital.

MBBS, FCPS, Assistant Professor Obs & Gynae,