From: Risk factors for relaparotomy after a cesarean delivery: a case-control study
Variable | Relaparotomy group N = 130 | Control group N = 260 | P-value |  |
---|---|---|---|---|
Gestational age (weeks) | 375/7 (30/7) | 382/7(20/7) | 0.19 | Â |
Pre-term delivery | 33 (25.4) | 37 (14.2) | 0.007 | Â |
Fever during labor | 9 (6.9) | 10 (3.8) | 0.183 | Â |
Placental abruption | 12 (9.2) | 5 (1.9) | < 0.001 |  |
Amniotic fluid | Â | Â | 0.032 | Â |
 Clear | 99 (76.2) | 221 (85) |  |  |
 Other (meconium or bloody) | 31 (23.8) | 39 (15) |  |  |
Maternal hemoglobin prior to CD (g/dl) | 12.2 ± 1.3 | 12.1 ± 1.1 | 0.224 |  |
Maternal platelet count prior to CD | 186.1 ± 62 | 202.8 ± 58.6 | 0.249 |  |
Time of CD | Â | Â | 0.286 | Â |
 Morning (7–15) | 62 (47.7) | 112 (43.1) |  |  |
 Evening (15–23) | 45 (34.6) | 111 (42.7) |  |  |
 Nighttime (23 − 7) | 23 (17.7) | 37 (14.2) |  |  |
Birthweight (grams)* | 2875 ± 799 | 3062 ± 642 | 0.015 |  |
CD type | Â | Â | 0.044 | Â |
 Elective | 60 (46.2) | 148 (56.9) |  |  |
 Urgent | 70 (53.8) | 122 (43.1) |  |  |
Primary surgeon | Â | Â | 0.128 | Â |
 Attending | 48 (36.9) | 117 (45) |  |  |
 Resident | 48 (36.9) | 117 (45) |  |  |
Second stage CD | 19 (14.6) | 15 (5.8) | 0.004 | Â |
General anesthesia | 12 (9.2) | 11 (4.2) | 0.048 | Â |
Cesarean duration, minutes | 41.5 ± 28.2 | 30.4 ± 11.6 | < 0.001 |  |
Calling for assistance | 25 (19.2) | 14 (5.4) | < 0.001 |  |
Intra-abdominal adhesions | 40 (30.8) | 51 (19.6) | 0.014 | Â |
Uterine incision extensions | 27 (20.8) | 18 (6.9) | < 0.001 |  |
Bladder injury during the CD | 0 | 2 (0.77) | N/A | Â |
Complicated CD** | 62 (47.7) | 70 (26.9) | < 0.001 |  |
EBL ≥ 1000 ml | 23 (17.7) | 14 (5.4) | < 0.001 |  |
TXA use during the CD | 18 (13.8) | 7 (2.7) | < 0.001 |  |
Use of a hemostatic agent | 52 (40) | 36 (13.8) | < 0.001 |  |
Use of a surgical suction drain | 11 (8.5) | 2 (0.8) | < 0.001 |  |
Excessive bleeding or the use of bleeding control measures *** | 61 (46.9) | 48 (18.5) | < 0.001 |  |
Tubectomy/tubal ligation | 7 (5.4) | 10 (3.8) | 0.413 | Â |
Suture of the uterus intra-abdominally | 6 (4.6) | 10 (3.8) | 0.649 | Â |
Packed red blood cell transfusion | 91 (70) | 4 (1.5) | < 0.001 |  |
Cesarean hysterectomy | 1 (0.8) | 0 | N/A | Â |
Uterine rupture | 2 (1.5) | 0 | N/A | Â |
Hysterectomy (excluding cesarean hysterectomy) | 13 (10) | 0 | < 0.001 |  |
Maternal death | 0 | 0 | N/A | Â |
DIC | 38 (29.2) | 0 | < 0.001 |  |
ICU admission | 57 (43.8) | 2 (0.8) | < 0.001 |  |
Thrombotic event | 3 (2.31) | 1 (0.4) | 0.126 | Â |
Paralytic ileus | 8 (6.2) | 1 (0.4) | < 0.001 |  |
Postpartum fever | 22 (16.9) | 2 (0.8) | < 0.001 |  |
Duration of hospitalization, days | 9.9 ± 7.9 | 5.4 ± 4.1 | < 0.001 |  |
Readmission | 33 (25.4) | 7 (2.7) | < 0.001 |  |
Future delivery at our institution | 8 (6.2) | 58 (22.3) | < 0.001 |  |