Pencole L, Peyronnet V, Mandelbrot L, et al. - In France, intra-abdominal hemorrhage after cesarean delivery is identified as the second cause of maternal death due to postpartum hemorrhage. Via performing a case-control study (1:2 ratio), researchers sought to determine the risk factors of relaparotomy for intra-abdominal hemorrhage (IAH) after cesarean delivery. In addition, they investigated clinical warning signs linked with IAH: heart rate > 120/min, systolic blood pressure < 90 mmHg, scar bleeding, unconsciousness or abdominal pain with visual analog pain scale > 7 or use of category 3 analgesic medications, in the post-anesthesia care unit and in the postpartum unit. Among a total of 19,007 women who had a cesarean delivery during the study period, 52 relaparotomies (0.27 %) were conducted for IAH. Comparison of 48 cases with 96 controls was performed. Findings revealed independent association of preeclampsia, urgent cesarean, surgical difficulties and blood loss > 500 mL during initial cesarean with an elevated risk of relaparotomy for IAH. Discriminant-warning signs for severe IAH were tachycardia and/or hypotension.