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Objective <p>Unplanned return to operation theatre (UROT) has been used as an indicator of surgical care quality. Relaparotomy and UROT in obstetrics is considered a maternal near-miss event. The purpose of this study was to determine reasons for UROT after major obstetric surgeries to identify opportunities for patient care quality improvement.</p> Methods <p>This is a single-center retrospective observational study over a period of 7&#xa0;years from January 2016 to December 2022 in a tertiary care teaching institution of Jharkhand, India. An unplanned return to the operation theatre in obstetrics was defined as return within 6&#xa0;weeks of the first operation (cesarean section or laparotomy for ruptured uterus or ectopic pregnancy) because of a complication of the primary surgery.</p> Results <p>Overall 63 cases (32 in-house and 31 referred cases) had UROT. The incidence of in-house UROT was 0.16% (32/19,422). Intraperitoneal hemorrhage 22 (34.92%) was commonest reason followed by PPH 12 (19%) and broad ligament hematoma 10 (15.87%). Primary surgery was an emergency procedure IN 92% cases. Previous cesarean 12 (19%), and obstructed labor 5 (7.9%) were the commonest indications of primary surgery. Hysterectomy was needed in 21 (33.33%). Most (63.5%) returns occurred within 24&#xa0;h. Twelve cases had maternal mortality.</p> Conclusion <p>Repeat surgeries in obstetrics often result from problems during primary surgery with substantial effects in terms of morbidity and cost. Tracking the rates of UROT may be useful in improving the quality of institutional care. The rates of reoperation may be reduced by following standard protocols and checklists.</p>

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Unplanned Return to Operation Theater in Obstetrics: An Institutional Analysis to Identify Areas of Quality Improvement

  • 期刊论文

  • 发表日期：

    2025年11月13日

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  • Archana Kumari,
  • Tanu Sharma

摘要

Objective

Unplanned return to operation theatre (UROT) has been used as an indicator of surgical care quality. Relaparotomy and UROT in obstetrics is considered a maternal near-miss event. The purpose of this study was to determine reasons for UROT after major obstetric surgeries to identify opportunities for patient care quality improvement.

Methods

This is a single-center retrospective observational study over a period of 7 years from January 2016 to December 2022 in a tertiary care teaching institution of Jharkhand, India. An unplanned return to the operation theatre in obstetrics was defined as return within 6 weeks of the first operation (cesarean section or laparotomy for ruptured uterus or ectopic pregnancy) because of a complication of the primary surgery.

Results

Overall 63 cases (32 in-house and 31 referred cases) had UROT. The incidence of in-house UROT was 0.16% (32/19,422). Intraperitoneal hemorrhage 22 (34.92%) was commonest reason followed by PPH 12 (19%) and broad ligament hematoma 10 (15.87%). Primary surgery was an emergency procedure IN 92% cases. Previous cesarean 12 (19%), and obstructed labor 5 (7.9%) were the commonest indications of primary surgery. Hysterectomy was needed in 21 (33.33%). Most (63.5%) returns occurred within 24 h. Twelve cases had maternal mortality.

Conclusion

Repeat surgeries in obstetrics often result from problems during primary surgery with substantial effects in terms of morbidity and cost. Tracking the rates of UROT may be useful in improving the quality of institutional care. The rates of reoperation may be reduced by following standard protocols and checklists.