Publication:

A five-year study of postpartum exploratory laparotomy in a tertiary care teaching hospital

Background Emergency postpartum exploratory laparotomy is a major surgical venture invariably performed in the setting of life threatening conditions during or immediately after abdominal and vaginal deliveries. Tertiary health care centers play a prime role in such cases to avoid any mishap. In spite of that sometimes sudden such incidences in the form of maternal morbidity or mortality occur which makes us think upon.

Methods A retrospective study was conducted in Dr. SCGMC, Nanded, a tertiary health care centre in Nanded Maharashtra, over a period of 5 years in the Department of OBGY i.e. between January 2012 to December 2016 of the cases who required postpartum exploratory laparotomy.

Results Out of the total deliveries in our hospital and cases referred from outside hospital from January 2012 to December 2016 i.e a span of 5 years including 62525 cases under study, 39 cases required postpartum exploratory laparotomy. We found that postpartum hemorrhage is the most common cause requiring postpartum exploratory laparotomy. Other causes requiring postpartum exploratory laparotomy are burst abdomen, puerperal sepsis, rectus muscle hematoma etc.

Conclusions In the era of modern obstetrics, to fulfill the main objective of obstetrics of having healthy mother and healthy baby at the end of pregnancy, postpartum exploratory laparotomy is a procedure done as an extreme measure to reduce maternal mortality and morbidity. We observed that majority of the patients who required exploratory laparotomy in postpartum period suffered morbidity in the form of prolonged hospital stay or transfusion of blood or blood products, need of ventilator support or ICU care. Though the patients suffered morbidity, mortality could be prevented by timely intervention in majority of the patients.