01/01/2020 - 31/12/2023
Intrahepatic Cholestasis of Pregnancy
01/01/2023 - 31/12/2024
Re-exploration after Caesarean Section
RE-EXPLORATION AFTER CAESAREAN SECTION
The prevalence of Caesarean Section (CS) is increasing worldwide (1-3) with around 21% of births in Belgium today being carried out by CS (4-6). Despite being a life-saving intervention in medically-indicated situations, research shows that a large proportion of these CSs are not medically advised (7).
Although safety of the procedure is increasing, women undergoing CS are exposed to short and long-term risks (7, 8). Surgical risks such as bleeding, wound infection or injury to surrounding organs might require a re-exploration. Re-laparotomy after CS comes with its own anesthetic and procedural risks, besides the increased risk of infection, blood transfusion, intensive care admission and increased length of hospital stay. The incidence of re-laparotomy is estimated to be between 0,1 and 1,0%, based on data obtained by retrospective single-center studies of small scope (9-16). Some of these studies have tried to determine risk factors for re-laparotomy after CS. Previous CS, emergent CS, placenta praevia, pre-eclampsia and longer operating time seemed to be the most found risk factors (9-17), but due to small numbers results were not conclusive. Therefore, larger, prospective investigations are necessary, as a better understanding of this severe complication is crucial to improve patient care.
The UKOSS (United Kingdom Obstetric Surveillance System) took the initiative to start up a survey on the complication within the International Network of Obstetric Survey Systems (18). Current study takes part of this INOSS initiative, gathering information on re-laparotomy after CS in Belgium. The primary aim of this study is to get knowledge about the incidence of re-laparotomy after CS in Belgium. Secondary aims are to determine risk factors and outcomes associated with re-exploration after CS in order to give better obstetric care and find preventive measures to reduce morbidity and mortality.
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18. Marian Knight NPEU. Re-exploration after Caesarean Section. UK obstetric Surveillance System (UKOSS); 2021.