Objective: To review the pregnancy outcome in patients with failed tubal sterilization treated in our hospital and to compare the incidence of ectopic pregnancy in our study group with the experience at other military hospitals and with the incidence of ectopic pregnancy in similar patients reported in the literature.
Study design: A registry of failed tubal sterilization was started at our hospital in 1989. We entered all information regarding the type of procedure and pregnancy outcome as the patients presented for care. Information on the experience at other military hospitals was obtained through review of data provided by the epidemiology section of the Health Services Command, San Antonio, Texas.
Results: From 1989 to 1991, 12 patients with failed tubal sterilization received care at our hospital. Eight patients (67%) had ectopic pregnancies. Of 137 patients identified through the Health Services Command, 49 (36%) had ectopic pregnancies.
Conclusion: The literature reports a 5-90% incidence of ectopic pregnancy after failed tubal sterilization. The data from our registry and from the Health Services Command corroborate the increased likelihood of ectopic pregnancy in patients with failed tubal sterilization and underscore the need for close follow-up of these patients until the location of the pregnancy is documented.
PIP: Various research studies have documented post-sterilization ectopic pregnancy rates ranging from 5% to 90%. To investigate this complication further, the pregnancy outcomes of the 12 women with failed tubal sterilizations who received care during 1989-91 at the Beaumont Army Medical Center in El Paso, Texas, and of 137 such patients at other Texas military hospitals during 1984-88 were reviewed. Ectopic pregnancies occurred in 8 (67%) women in the former group and 49 (36%) in the latter. The incidence of ectopic pregnancy was similar for minilaparotomy, cesarean section-associated sterilization, and laparoscopy, indicating that there is no significant advantage associated with any one procedure. A post-sterilization pregnancy may be due to tubal recanalization or to a proximal fistula. Recommended is the practice of electrocoagulating both cornual regions to cause scarring of the myometrium and closing of any fistula.