Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the treatment of pain, inflamation and fever. They are usually well tolerated in healthy persons, but in patients with risk factors (advanced age, renal impairment, heart failure, liver disease, concurrent medications with antihypertensive drugs), NSAIDs can induce serious renal adverse effects. They include sodium and water retention with edema, worsening of heart failure, hypertension, hyponatremia, hyperkalemia, acute kidney injury, chronic kidney disease, renal papillary necrosis and acute interstitial nephritis. The majority of these adverse effects are due to the inhibition of prostaglandins synthesis and they are dose and duration-dependent. Acute forms of kidney injuries are transient and often reversible upon drug withdrawal. Chronic use of NSAIDs in some patients may result in chronic kidney disease. It is recommended that patients at risk should have preventative strategies in place, including the use of the "lowest effective dose" of NSAID for the "shortest possible time" and monitoring renal function, fluid retention and electrolyte abnormalities. Patients who are taking antihypertensive medications should be monitored for high blood pressure and the doses of antihypertensive medications should be adjusted if needed. In general, the combination of NSAIDs and angiotensin inhibitors should be avoided. Some other preventive measures are dietary salt restriction, use of topical NSAIDs/non-pharmacological therapies and use of calcium channel blockers for treating hypertension.

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The application of rFVIIa reduced haemorrhage in our patient, both after the Caesarean section and after hysterectomy, contributing to the patient's full recovery, without neurological sequelae and with preserved renal function. RFVIIa is not an alternative to surgical haemostasis, but its administration should surely be considered before deciding to perform hysterectomy, especially in patients who want to preserve fertility. In cases of postpartum haemorrhage, when bleeding persists even after adequate surgical haemostasis, the administration of rFVIIa is to be considered not only as an alternative to hysterectomy, but also an effort to prevent significant maternal morbidity and mortality.

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Introduction/Objective Cesarean section birth rate has been constantly increasing worldwide over the last decades. The complications of cesarean section that require relaparotomy are rather serious and relatively rare. The aim of this paper is to present the incidence of surgical complications after Cesarean section at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia, during a three-year period (2013-2015). Methods This is a retrospective study. Data obtained from the medical records/histories were used and processed according to descriptive statistical methods. Results During the observed period, relaparotomy was necessary in 29 (0.44%) women who had a CS. Relaparotomy was performed due to clinically and ultrasonographically evidenced hematoma of the anterior abdominal wall, retroperitoneal hematoma, hemoperitoneum, and development of hemorrhagic shock, complete wound dehiscence or diffuse peritonitis. There were no lethal outcomes after CS followed by these complications at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia in Belgrade. Conclusion The incidence of relaparotomy in our study is similar to other tertiary institutions, as well as the indications for relaparotomy. While generally observed mortality rate after post-cesarean relaparotomy in developed countries is 2.7%, in our study there were no lethal outcomes.