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Int J Gynaecol Obstet. 1988 Oct;27(2):255-63.

Analysis of sterilization failure in Brazil.

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Centro de Pesquisas de Assistencia Integrada à Mulher e à Criança (CPAIMC), Rio de Janeiro, Brazil.


A study of 13,423 female sterilization procedures performed from 1981 to 1984 in Rio de Janeiro, Brazil, was conducted to determine the level of sterilization failure. The lifetable cumulative failure rate was 0.54 at 12 months per 100 initial sterilizations, increasing to 1.04 at 48 months. Results of a multivariate analysis indicated that the differential in the rate of sterilization failure by woman's age at sterilization at 12 and 24 months was statistically highly significant. However, the differential rate of failure by the other variables such as whether sterilized during a training period, number of sterilizations per surgeon per day, and year of sterilization were not statistically significant.


To determine the level of sterilization failure, an analysis of the 13,423 female sterilization procedures carried out in 1981-84 at a primary care center in Rio de Janeiro was performed. 97% of these procedures were performed with a laparoscope, and a band was used for 98% of occlusions. 144 women reported a pregnancy after their sterilization procedure; of these, 22 were defined as occurring before the surgery (luteal phase) and were excluded from the life-table analysis. The cumulative failure rate was 0.54/100 sterilizations at 12 months and 1.04/100 procedures at 48 months. Parity, method of sterilization, and occlusion technique were not correlated with sterilization outcome. However, logistic regression analysis indicated that the rates of sterilization failure at 12 and 24 months were consistently lower for older women (age 30 years and above) than women in the 17-29-year age group. (p0.01). The number of sterilizations performed per day was also a factor in sterilization failure, but this association was not statistically significant. 5.7% of the sterilization failures resulted in ectopic pregnancies. Overall, these findings are comparable to the failure rate in other countries. The occurrence of 22 luteal phase pregnancies in this study highlights the importance of thorough preoperative counseling and examination. It is recommended that contraception should be used in the cycle prior to sterilization to reduce this risk.

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