DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213836

Failed tubectomy procedures: a retrospective study

Balaji J. Jadhav, Mangala Gomare, Vaishali Chandanshive

Abstract


Background: It is difficult to understand the nature of factors leading to failure of sterilization from single institute. Knowing the factors, we can take preventive measures. Those data were of women who filed claims under Family Planning Indemnity Scheme, 2013 (revised 2016). The scheme was not reached at grassroots; therefore, not enough women got the benefit of this scheme. We gave the list of documents as well, which help medical fraternity working in rural area.

Methods: Retrospective study of 32 women of failed tubal ligation over a period of four years (from 2016 to 2019). The variables under consideration of study were, parity and age at the time of tubectomy. Time and method of tubectomy. Interval between tubectomy and subsequent pregnancy. Outcome of subsequent pregnancy and further contraceptive acceptance. Descriptive statistics used for frequency analysis.

Results: Median age of women was 26 years during tubal sterilization. Seventy two percent women were accepted sterilization on two children. Sixty nine percent of tubal sterilization were performed in puerperium; concurrent with caesarean section and medical termination of pregnancy, while 31% were during interval period. Thirty four percent of women became pregnant within 24 months(2years) of sterilization and cumulative 75% within 60 months (5 years) after sterilization. Sixty nine percent of women had intrauterine pregnancies and 31% ectopic pregnancies. Fifty six percent women accepted medical termination of pregnancy and 53% chosen repeat tubal sterilization. Four women (12%) gave live births. Two of them accepted repeat sterilization and another two intrauterine contraceptive devices. Thirty one percent women had ectopic pregnancy; nine of them came as ruptured ectopic, therefore, exploratory laparotomy with bilateral total salpingectomy were to be performed.

Conclusions: Failed tubal sterilization is common when it was performed at younger age and in puerperium. Missed period after sterilization should have high index of suspicion of ectopic pregnancy, which leads to severe maternal morbidity.


Keywords


Failed tubal sterilization, Failed tubectomy, Failed female sterilization, Ectopic pregnancy

Full Text:

PDF

References


United Nations. Contraceptive Use by Method 2019: Data Booklet (ST/ESA/SER.A/435). 2019. Available at: www.digitallibary.un.org/record. Accessed on 10 May 2021.

Annual population report. 2017-2018. Ministry of Health and Family Welfare, India. Available at: HMIS portal, www.hmis.nhp.gov.in. Accessed on 10 May 2021.

Osborn JA, Rm S, Karthikeyan S, Ravishankar SL. A study on contraceptive prevalence rate and factors influencing it in a rural area of Coimbatore, South India. J Family Med Prim Care. 2021;10:2246-51.

Dudley and Stephen (2017). Sterilization at the time of caesarean section (patient information) Available at http:/ www.uhcw.nhs.uk. Accessed on 10 May 2021.

Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization. Am J Obstet Gynecol.1996;174(4):1161-68.

Hamdani. A comparison between two methods of tubal ligation for sterilization of woman in a rural hospital (Short Communication). J Bacteriol Mycol. 2021;9(1):30-1.

Aziz F, Kruthi R. Clinical study of tubectomy and it’s complications. Int J Reprod Contracept Obstet Gynecol. 2020; 9(6):2550-5.

Brandi K, Morgan JR, Paasche-Orlow MK, Perkins RB, White KO. Obstetric Outcomes After Failed Hysteroscopic and Laparoscopic Sterilization Procedures. Obstet Gynecol. 2018;131(2):253-61.

Date SV, Rokade J, Mule V, Dandapannavar S. Female sterilization failure: Review over a decade and its clinicopathological correlation. Int J Appl Basic Med Res. 2014;4(2):81-5.

Purwar B, Patel V, Patel M. Factors affecting sterilization operation among couples of a rural area in Ahmedabad: A record-based study. Indian J Med Sci. 2012;66:267-72.

Tahmina S, Daniel M, Solomon P. Clinical Analysis of Ectopic Pregnancies in a Tertiary Care Centre in Southern India: A Six-Year Retrospective Study. J Clin Diagn Res. 2016;10(10):QC13-6.

Rathod S, Samal S. Clinical analysis of post sterilization failure cases in a tertiary hospital. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3294-96.

Vincent V, Saha MK. A Study on Post-Sterilisation Failure in a Tertiary Care Hospital. Rec Adv Path Lab Med. 2019;5(3):5-7.

Mahadevappa K, Prasanna N, Channabasappa RA. Trends of Various Techniques of Tubectomy: A Five-Year Study in a Tertiary Institute. J Clin Diagn Res. 2016;10(1):QC04-7.