French AmbUlatory cesarean section (FAUCS) versus low-segment cesarean section: Operative and postoperative complications, a retrospective comparative study.

Abstract Purpose We compared operative and postoperative results of French AmbUlatory cesarean section (FAUCS) and low-segment cesarean section (LSCS). Methods This retrospective cohort study assessed operative and postoperative results of 125 women who underwent FAUCS and 172 women who underwent LSCS in a tertiary hospital in Israel, during a one-year period. Results For the FAUCS compared to the LSCS procedure, the overall median operation time was 5min longer and the cutting time - fetal extraction interval was 3min longer. Smaller proportions of women who underwent FAUCS than LSCS had excessive intraoperative blood loss, defined as > 1000ml (2.4% vs. 9.3%, p = 0.017), a hemoglobin drop > 3gr/dL (1.6% vs. 7.6%, p = 0.029) and needed iron transfusion for postoperative hemoglobin < 7 gr/dL (0.8% vs. 7%, p = 0.009). The groups were similar in baseline characteristics, rates of intra-operative complications, blood transfusion, surgical site infection, endometritis, ileus and postpartum hemorrhage. The sum of postoperative complications was lower in FAUCS than LSCS (1.6% vs. 8.7%, p = 0.010). Early mobilization and spontaneous urination were achieved at a median of 5h (range 3–9) following FAUCS, and 18h (range 10–24) following LSCS. The median 24h pain visual analogue score was lower after FAUCS than LSCS (1.2 vs. 2, p < 0.001). Conclusion The operation was slightly longer in FAUCS than LSCS, but without clinical significance. Blood loss was less and postoperative complications were less frequent in FAUCS than LSCS. Our FAUCS protocol achieves early mobilization, early spontaneous urination and lower pain than LSCS at 24h.