Normal prenancy following tubouterine implantation

Abstract

T HERF is a very extensive literature on various operative procedures for steriljzation and subsequent pregnancies following such procedures. Some such pregnancies were normal uterine pregnancies with normal deliveries and others were extrauterine. We refer primarily to operations performed for t,he purpose of sterilization. But, unfortunately, many surgeons are in the habit of removing tubes indiscriminately, when the tubes need either no surgery or some minor plastic procedure, such as opening a closed flmbriated end or excising some ronstricting fibrous bands. While modern pelvic surgery in honest, capable hands leans toward ~reservatioI~, it would appear that the ovary is the main beneficiary in t,his change of attitude, which has come a.bout only too slowly. And even here, many surgeons are only too prone to remove an ovary which needs either no surgery or only the puncture or removal of some cysts, or, at most, only a partial resection, since half an ovary is better than no ovary, a,nd u woman can become pregnant with half an ovary and one tube (even a poor and distorted tube). We believe the matter of depriving a woman in the childbearing a.ge of nlot,herhood is one that. has not been given enough serious thought. The uterus itself is only too often removed by surgeons who are either uns~r77pulous or ignorant of ut,erine pathology. This is not a subject for discussion here. We have compiled a list of 125 references relative to the operative pro~tlures of establishing fecundity following operations for sterilization and allied subjectSa. These references are in Spanish, French, German and English: We have most of the articles in foreign languages either translated verbatim or ~tl~stracted, and we have read most of these articles, but believe it will serve no useful purpose to list them all with this article. They cannot all be referred to here, and anyone interested in this subject, is familiar with the vast literature on sterilization and methods to correct this condition. Anyone not interested would not appreciate the amount, of study involved and would not use the references. We shall merely list the references quoted here, and attempt to give some idea of the infrequency of pregnancy following such corrective surgery. As above stated, pregnancy has followed sterilization operations in many eases. It has also, in many instances, f5~~owed surgery not perfor~led for the purpose of sterilization but which was, by its very nature, sterilizing in character, such as bilateral salpingectomy and/or oophorectomy and hysterectomy. Here ill7 operative procedure to correct sterilization is most called for, but, in our case, the patient was sterilized “on purpose ” in a State Institution. The details will be given later.