{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T19:07:52Z","timestamp":1776280072918,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,1,27]],"date-time":"2005-01-27T00:00:00Z","timestamp":1106784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2005,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of the study was to find out the indications for management and the outcomes of reopening the abdomen during the puerperium after Cesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>This was a retrospective descriptive survey at the Korle Bu Teaching Hospital in Accra, Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 6120 Cesarean sections (17%) out of a total of 36,010 deliveries. Re\u2010laparotomy was done in 44 patients (0.7%) of the Cesarean sections. The indications were: hemorrhage from uterine atony, hemorrhage from placental bed after operation for placenta previa, uterine sepsis with hemorrhage, hemorrhage after Cesarean section, myomectomy and hemorrhage from anterior abdominal wound dehiscence. The main surgeries performed were: hysterectomy, ligation of ascending branches of uterine arteries, ligation of hypogastric arteries, debridement and re\u2010suturing of the uterine incision and secondary suturing of anterior abdominal wall. There were 6 near missed fatalities. There were 4 mortalities caused by excessive hemorrhage and severe sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The case fatality rate for re\u2010laparotomy after Cesarean section is high (9%). Near missed\u2010fatalities are common. To reduce the unfavorable outcomes, instituting more intensive education on the use of the partograph should prevent prolonged labor. Centers carrying out Cesarean section should have efficient blood transfusion service in place.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2004.12.014","type":"journal-article","created":{"date-parts":[[2005,1,29]],"date-time":"2005-01-29T08:48:09Z","timestamp":1106988489000},"page":"253-257","source":"Crossref","is-referenced-by-count":44,"title":["Re\u2010laparotomy after Cesarean section"],"prefix":"10.1002","volume":"88","author":[{"given":"J.D.","family":"Seffah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,1,27]]},"reference":[{"issue":"2","key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/01443619867812","article-title":"The influence of maternal request on the elective Cesarean section rate","volume":"18","author":"Jackson N.V.","year":"1998","journal-title":"J. Obstet. Gynaecol."},{"key":"e_1_2_6_3_2","first-page":"657","volume-title":"Obsterics: normal and problem pregnancies","author":"Depp R.","year":"1991"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(81)90485-3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.4.480"},{"key":"e_1_2_6_6_2","first-page":"10","article-title":"Severe obstetric morbidity of the 3rd trimester, delivery and early puerperium in Niamey (Niger)","volume":"2","author":"Prual A.","year":"1998","journal-title":"Afr. J. Reprod. Health"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb01723.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1001\/jama.1990.03440240076019","article-title":"International differences in the use of obstetric interventions","volume":"263","author":"Notzon F.C.","year":"1990","journal-title":"J. Am. Med. Assoc."},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0020-7292(94)90255-0"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(01)00377-0"},{"key":"e_1_2_6_11_2","first-page":"779","article-title":"Rupture of the gravid uterus; a review of 97 cases","volume":"31","author":"Amaniampong K.","year":"1997","journal-title":"Ghana Med. J."},{"key":"e_1_2_6_12_2","first-page":"250","article-title":"The outcome of pregnancy and labor following previous Cesarean section at Korle\u2010Bu Teaching Hospital","volume":"14","author":"Klufio C.A.","year":"1973","journal-title":"Ghana Med. J."},{"key":"e_1_2_6_13_2","first-page":"423","article-title":"Delivery of the impacted fetal head at Cesarean section; surgical technique","volume":"28","author":"Ghosh T.S.","year":"1992","journal-title":"Ghana Med. J."},{"key":"e_1_2_6_14_2","first-page":"70","article-title":"Surgical control of obstetric hemorrhage","volume":"24","author":"Clark S.L.","year":"1984","journal-title":"Contemp. Ob\/Gyn"},{"key":"e_1_2_6_15_2","first-page":"376","article-title":"Emergency hysterectomy for the control of obstetric hemorrhage","volume":"64","author":"Clarke S.L.","year":"1984","journal-title":"Obstet. Gynecol."},{"key":"e_1_2_6_16_2","first-page":"89","article-title":"Placenta previa\/percreta and prior Cesarean section","volume":"66","author":"Clark S.L.","year":"1985","journal-title":"Obstet. Gynecol."},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1997.tb02263.x"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)70582-9"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2003.01133.x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.140.2.7196055"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729205000238?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729205000238?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2004.12.014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2004.12.014","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2004.12.014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T02:54:43Z","timestamp":1696388083000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2004.12.014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,1,27]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2005,3]]}},"alternative-id":["10.1016\/j.ijgo.2004.12.014"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2004.12.014","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,1,27]]}}}