Extraperitoneal C-Section
What is it?
An Extraperitoneal C-Section (ECS) is a surgical procedure of delivering a baby through an incision in the lower uterine segment. In ECS, the uterus is approached through the paravesical space and the peritoneal cavity is not entered. The main advantage of this procedure is that it is less invasive, as it helps prevent the spread of infection from the uterus into the peritoneal cavity. Since it is less common than the traditional C-Section, Extraperitoneal C-Section surgery requires focused training and specialization.
What are the benefits?
In addition to lessening the spread of infection to the peritoneal cavity and being less invasive on tissue, ECS resembles a natural birth experience. A few hours after the operation, the mother can get up and walk independently, and the use of a urinary catheter is not necessary. She can shower the same day and eat normally, as the ECS procedure comes with reduced post-operative pain.
ECS is also a good alternative to transperitoneal delivery or cesarean hysterectomy if there is a case of a uterine infection—whether that is proven or presumed.
ECS, overall, presents a lower risk of complications than the traditional C-Section and has the added advantage of reduced postoperative pain. As a result, both the time of recovery and the cost of the procedure are relatively low; many mothers can be discharged in less than 24 hours and because of the short stay in the hospital and the reduced use of analgesics they are not faced with a huge birth cost.
What are the risks?
Studies have concluded that there are no significant risks associated with ECS. Although it is a procedure meant to reduce the risk of infection, we should remain aware that post-operative infections may still occur—even if we have a large number of antibiotics available at our disposal. The studies done to compare ECS to traditional C-Section methods showcase that there is no significant difference in morbidity and mortality rates between the two, but they do seem to be suggesting that ECS is a lengthier procedure—despite the reduced post-operative time.
How common is it and what makes someone a good candidate?
Not all OBGYNs are trained to perform ECS; though it is a procedure that presents a rational basis to prevent infections and has benefits in anatomic training, it still requires extreme specialization to be carried through. As such, if there is evidence of an intrauterine infection or if one is presumed, this makes ECS a good solution. Similarly, it is viable in cases of labor over 24 hours, ruptured membranes over 24 hours, as well as six or more vaginal examinations.
We are proud to provide our patients with the very best in treatment methods to help ensure a new generation of Western New York babies is brought into this world safely. For women who may require a cesarean section, your OBGYN will help you determine if an extraperitoneal cesarean is right for you.
If you have questions about Extraperitoneal Cesarean Surgery available from our practice, and whether it may be appropriate for you, contact us today.