Feasibility and Safety of Laparoscopy in Pregnancy in Yaoundé, Cameroon

Introduction: Laparoscopy, a minimally invasive surgical technique, has revolutionized the management of various abdominal and pelvic conditions globally. Its application during pregnancy, once considered contraindicated due to potential risks such as fetal hypoxia, uterine injury, and preterm labor, is now increasingly recognized as a safe and effective approach when performed by skilled surgeons under appropriate conditions. In Cameroon, the practice of laparoscopy remains limited, particularly in the context of pregnancy where data are lacking. This study aims to address this gap by exploring the application of laparoscopy in pregnant patients in Yaoundé, Cameroon, with a focus on its feasibility and safety. Methods: From January 1, 2019, to December 31, 2024, we conducted a retrospective, descriptive cross-sectional study at Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH), Cameroon. We included all pregnant women who underwent laparoscopic surgery during pregnancy. Data analysis was done by IBM SPSS 24, and results were expressed as mean, frequency and percentage. Results: A total of 896 patients underwent laparoscopic surgery during the study period and 24 patients had an active intrauterine pregnancy, giving a frequency of 2.6%. The mean age was 28.1 ± 4.1 years. Primiparous women were the most common with 59.1% of cases. Twenty-one (95.4%) pregnancies were mono-fetal with one heterotopic pregnancy. Of 22 laparoscopies performed, 15 (68.2%) were during the first trimester and 7 (31.8%) during second trimester. The gestational age ranged from 7 to 13 weeks. The main indications for surgery were adnexal torsion (40.9%) and a large ovarian cyst (31.8%). No intraoperative complications were reported. The main pregnancy outcomes included one miscarriage at 18 weeks, one preterm vaginal delivery at 32 weeks and 20 (95.5%) term vaginal delivery. All Apgar score were > 7. The fetal weight ranged from 1800 g to 3500 g. After delivery, no fetal and maternal complications were recorded. Conclusion: Laparoscopic surgery during pregnancy is uncommon and seems to be feasible and safe in first and second trimester.