Analysis of factors for failure of female sterilization – A Retrospective study

Pratima Agarwal; Paapa Dasari; Venkateswara

Volume : VIII, Issue : IX, September - 2018

Analysis of factors for failure of female sterilization – A Retrospective study

Pratima Agarwal, Paapa Dasari, Venkateswara

Abstract :

Objectives–The primary objective of this study is to determine the possible etiological factors and clinicodemographic profile amongwomen with sterilization (ST) failure and secondary objective is to find out the time to failure and outcome of pregnancy following sterilizationfailure.

Material and Methods–

This is a retrospective record–based study which included all women in whom sterilization was carried out and have reported as tubal sterilizationfailureadmitted to Department of Obstetrics and Gynaecology, JIPMER during the period of 6 years (January 2012 to December 2017).

Results–During the above period, 82 women with sterilization failure were admitted. The mean interval after sterilization was23 months with a range from 2 months to 117 months. Thirty–eight (46.34%) were following puerperal sterilizations (PS), 24 (29.27%) occurred after concurrent sterilizationwith lower segment Caesarean section (LSCS),7(8.54%) were after interval minilaparotomy tubal ligations (minilap TL),7 (8.54%) were following laparoscopic tubal ligations (Lap TL) and 6 (7.31%) were following postabortalminilaparotomy sterilizations.

Sixty–seven (82.71%) women reported failure prior to12 weeks of gestation and the rest approached beyond 12 weeks. Sixty–five (79.27%) of them were intrauterine pregnancy and 17 (20.73%) were ectopic pregnancy.Among the intrauterine pregnancies, 43 underwent MTP and 22 women continued pregnancy to term. Seventy (85%) underwent resterilizationthe causes of failure were of spontaneous recanalization in 41 (50%), formation of tuboperitonealfistula in24(29.27%) andimproper laparoscopic falope ring placementin5 (6.1%).Of the 17 women with ectopic pregnancy 16 underwent laparotomy/laparoscopy and spontaneous recanalization was reported in 15 cases (88.23%). The mean duration of sterilization failure was 23 months.

Conclusion: The most common etiological factor for sterilization failure was spontaneous recanalization. The pregnancy was intrauterine in 80% and ectopic in 20%. More than 80% reported in first trimester and 61% of them opted for MTP. Twenty–two (26.83%) of women continued pregnancy to term and over–all 70(85.37%) underwent resterilization along with MTP, concurrent with LSCS or after delivery and at the time of surgical management for ectopic pregnancy.