French Ambulatory Cesarean: Mother and Newborn Safety

OBJECTIVE To evaluate mother and newborn child safety after French ambulatory cesarean (FAUCS). METHODS Prospective comparative cohort study in Tunisia (January-June 2018). Pregnant women indicated for primary or repeat cesarean at term underwent FAUCS or Misgav Ladach cesarean (MLC). Surgical outcomes, overall morbidity, and maternal autonomy during recovery were compared. RESULTS Among 112 deliveries, 60 were performed by FAUCS and 52 by MLC. FAUCS was feasible in all cases; surgeons achieved a completely extraperitoneal approach in 39 (65.0%) cases. The main difficulty experienced was fetal extraction. Longer operative procedures were recorded in the FAUCS group; however, women in the FAUCS group reported lower pain scores (3 [2-5] vs 4 [3.7-5], P<0.001) and were more likely to decline analgesics (10 [17.0%] vs 0 [0%], P<0.001). They experienced greater autonomy during recovery (median [interquartile range] time to standing, 2 [1.0-2.5] vs 12.8 [8.9-17.9] hours, P<0.001; time to full meal, 4 [3-6[ vs 26.5 [21-31] hours, P<0.001; effective time to hospital discharge, 1 [1, 2] vs 2 [2, 3] days; P<0.001). CONCLUSION Implementation of the FAUCS technique was safe and successful, and improved maternal condition after cesarean. These short-term results need long-term validation by randomized trials.