{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:41:43Z","timestamp":1767919303253,"version":"3.49.0"},"reference-count":53,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T00:00:00Z","timestamp":1722384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012373","name":"National Institute of Academic Anaesthesia","doi-asserted-by":"publisher","award":["WKR0\u20102019\u20100063"],"award-info":[{"award-number":["WKR0\u20102019\u20100063"]}],"id":[{"id":"10.13039\/100012373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Re\u2010exploration following caesarean birth and the associated maternal morbidity has not been investigated in the UK. Our aims were to determine the national incidence and identify the associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational case\u2013control study across 194 UK consultant\u2010led maternity units in women whose caesarean birth was complicated by a re\u2010exploration. Independent factors for re\u2010exploration were analysed using multivariable multi\u2010level mixed effects logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the study period (1 June 2021 and 31 May 2022) 238,423 caesarean births were recorded across the UK of which 187 women underwent re\u2010exploration, giving an incidence of one re\u2010exploration per 1282 caesarean births (95%CI 1:1099\u20131:1471). Haemorrhage (124\/187, 66.3%) and sepsis (31\/187, 16.6%) were the most common findings at re\u2010exploration. Median (IQR [range]) time interval to re\u2010exploration following the caesarean birth was 1 (0\u20134 [0\u201328]) day. Mechanical ventilation was required in 34 (18.6%) women, cardiac arrest was reported in 5 (2.7%) and 3 (1.6%) women died. Independent preceding factors associated with a re\u2010exploration included: receipt of blood transfusion (adjusted OR (95%CI) 8.25 (2.66\u201325.61)); use of a general anaesthetic (adjusted OR (95%CI) 3.33 (1.61\u20136.88)); pre\u2010eclampsia (adjusted OR (95%CI) 3.27 (1.55\u20136.91)); black ethnicity (adjusted OR (95%CI) 3.14 (1.39\u20137.11)); postpartum haemorrhage (adjusted OR (95%CI) 2.82 (1.81\u20134.37)); use of anticoagulants or antiplatelet drugs pre\u2010caesarean birth (adjusted OR (95%CI) 2.26 (1.35\u20133.81)); and emergency caesarean birth (adjusted OR (95%CI) 1.89 (1.01\u20133.57)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Re\u2010exploration following caesarean birth in the UK is uncommon but is associated with significant maternal morbidity and mortality. These study findings will help guide informed consent and encourage appropriate surveillance of high\u2010risk women postpartum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16392","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T15:23:57Z","timestamp":1722439437000},"page":"1191-1200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Re\u2010exploration following caesarean birth: a prospective national case\u2013control study using the United Kingdom Obstetric Surveillance System (\n                    <scp>UKOSS<\/scp>\n                    ) data collection system"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8108-1196","authenticated-orcid":false,"given":"Kailash","family":"Bhatia","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Peri\u2010operative Medicine, Saint Mary's Hospital Manchester University NHS Foundation Trust  Manchester UK"},{"name":"University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-4262","authenticated-orcid":false,"given":"Malachy","family":"Columb","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Wythenshawe Hospital Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Vause","sequence":"additional","affiliation":[{"name":"Saint Mary's Managed Clinical Service Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102021\u2010005671"},{"key":"e_1_2_6_3_1","unstructured":"NHS Digital.Maternity Services Monthly Statistics January 2022 experimental statistics. 2022.https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/maternity\u2010services\u2010monthly\u2010statistics\/january\u20102022\u2010experimental\u2010statistics(accessed 07\/03\/2024)."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000152760.34443.86"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2011.03267.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40748\u2010017\u20100051\u20103"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0301\u20102115(97)02725\u20105"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tog.12280"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010018\u20101688\u20102"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010008\u20100604\u20109"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.5455\/medarh.2014.68.41\u201043"},{"key":"e_1_2_6_12_1","first-page":"19","article-title":"Indications and outcome of relaparotomy after a caesarean section","volume":"45","author":"Biswas SP","year":"2012","journal-title":"Bangladesh Med J"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.04.034"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.03.028"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2005.00609.x"},{"key":"e_1_2_6_16_1","unstructured":"National Institute for Health and Care Excellence.Caesarean birth. 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