Abstract
The present paper reports on 21 tubal pregnancies which have occurred after tubal sterilization in Tübingen or elsewhere since 1975. The proportion of tubal pregnancies amongst sterilization failures was 75%. The interval between sterilization and the occurrence of the tubal pregnancy ranged between 5 months and 7-3/4 years. The most frequent symptoms of the tubal pregnancies were pain (15/21), amenorrhea (11/21) and vaginal bleeding (5/21). Only 11 of the 21 patients were admitted to the clinic with the (suspected) diagnosis of an extra-uterine pregnancy. In 20 of the 21 patients the pregnancy was located in the distal (ampullar) segment of the tube; in 8 cases the tube was ruptured. Thirteen patients were treated by bilateral and 5 by unilateral salpingectomy, and a further 3 by unilateral adnexectomy. Summarizing, a considerable number of pregnancies occurring after unsuccessful tubal sterilization are extra-uterine. They are often not recognized, or only at a late stage. In the authors' view the patient should be informed of the possibility of a tubal pregnancy prior to sterilization.
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