TITLE:
Clinical Outcomes and Feasibility of the Extraperitoneal Cesarean Section: Insights from the Yaoundé Gynecological, Obstetric, and Pediatric Hospital
AUTHORS:
Isidore Tompeen, Jacques Tonye, Junie Yaneu, Cliford Ebong, Loïc Meukem Tatsipie, Julius Dohbit Sama, Esther Ngo Um Meka, Pascal Foumane, Robinson Mbu
KEYWORDS:
Extraperitoneal Caesarean Section, Maternal Morbidity, Postoperative Recovery, HGOPY, Cameroon
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.12,
December
25,
2025
ABSTRACT: Introduction: The extraperitoneal cesarean section (ECS) offers a compelling alternative to the conventional transperitoneal approach. Its core advantage lies in potentially reducing maternal morbidity. This technique specifically aims to lower infectious complications and enhance postoperative recovery. We report our experience and perioperative outcomes with ECS at a major referral hospital in Cameroon. Methods: A prospective observational, descriptive study was conducted in our maternity unit from August to September 2021. Among 201 deliveries, 69 were cesarean sections. From these, we included 11 cases of ECS, representing a frequency of 15.94%. We excluded patients with a scarred uterus, prior major surgery, grade 2 or higher obesity, a praevia obstacle, macrosomia, or any life-threatening condition for mother or fetus. Sociodemographic, clinical, intraoperative, and postoperative data were collected and analyzed. Results: Attempted rate of ECS was 15.94%. The procedure was successful in 81.81% of cases (9/11), with two conversions to transperitoneal section due to difficulty in fetal extraction. The average patient age was 29 years. The primary indications for surgery were non-reassuring fetal status (27.27%) and severe preeclampsia (18.18%). Spinal anesthesia was used exclusively. The mean fetal extraction time was rapid, at 1 minute and 56 seconds. Average operative duration was 34 minutes and 17 seconds. Intraoperative blood loss was minimal, remaining under 500 ml for 81.8% of patients. Complications included one bladder injury and two minor peritoneal breaches. Postoperative outcomes were notably positive. Most patients (72.73%) reported only minimal or moderate pain. Nearly half (45.45%) required no analgesics within the first 24 hours. Bowel function returned immediately for 72.73% of women, and the same proportion reported satisfactory early mobility. Conclusion: Our preliminary series from HGOPY demonstrates that the extraperitoneal cesarean section is a feasible technique. It is associated with low intraoperative morbidity and an excellent early recovery profile, particularly regarding pain, mobility, and return of bowel function. These promising results confirm the value of ECS for improving postoperative care pathways. It represents a compelling alternative to the conventional technique, certainly deserving of further evaluation through comparative studies.