Postpartum Tubal Sterilization Research Articles

Laparoscopic Postpartum Tubal Sterilization in the Morbidly Obese Patient

Traditionally, the Pomeroy ligation via minilaparotomy has been the most common method of postpartum tubal sterilization. However, in the obese patient, achieving adequate exposure using this technique is particularly difficult due to the depth of adipose tissue. We report on a small series of five morbidly obese women with body mass indix (BMI)>35 who underwent laparoscopic postpartum tubal sterilization under general anesthesia within 48 hours of vaginal delivery. Operating room time was less than that for women of similar weights operated on by minilaparotomy. In our series, there were no intraoperative or postoperative complications and the patients were discharged to home on second day postpartum. We have found that for morbidly obese women, laparoscopic postpartum tubal sterilization appears to be safe and effective in the hands of the experienced laparoscopist. (J GYNECOL SURG 20:89)

Laparoscopic Postpartum Tubal Sterilization in the Morbidly Obese Patient

Traditionally, the Pomeroy ligation via minilaparotomy has been the most common method of postpartum tubal sterilization. However, in the obese patient, achieving adequate exposure using this technique is particularly difficult due to the depth of adipose tissue. We report on a small series of five morbidly obese women with body mass indix (BMI)>35 who underwent laparoscopic postpartum tubal sterilization under general anesthesia within 48 hours of vaginal delivery. Operating room time was less than that for women of similar weights operated on by minilaparotomy. In our series, there were no intraoperative or postoperative complications and the patients were discharged to home on second day postpartum. We have found that for morbidly obese women, laparoscopic postpartum tubal sterilization appears to be safe and effective in the hands of the experienced laparoscopist. (J GYNECOL SURG 20:89)

Postpartum tubal sterilization: ACOG committee opinion: Committee on obstetrics: Maternal and fetal sterilization

International Journal of Gynecology & ObstetricsVolume 39, Issue 3 p. 244-244 ACOG committee opinion Postpartum tubal sterilization ACOG committee opinion: Committee on obstetrics: Maternal and fetal sterilization First published: November 1992 https://doi.org/10.1016/0020-7292(92)90666-7Citations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume39, Issue3November 1992Pages 244-244 RelatedInformation

Successful sustained lactation following postpartum tubal ligation

This study was undertaken to see whether tubal ligation performed within days postpartum, and associated with a delay in the initiation of breastfeeding, exerts a disruptive influence on successfully establishing lactation among the rural population of northern Thailand. Lactational performance of 12 rural northern Thai mothers was not affected by the delay in reunion of mothers with their babies as a result of postpartum tubal sterilization procedure when compared with a group of 8 other healthy mothers and babies. The volume of breast milk transferred, frequency of breastfeeding and the total feeding time spent on the breast were similar on days 15, 45, 90, 180 and 360 postpartum. This finding suggests that the pattern of intense breastfeeding activity as practiced by this group of mothers has a stronger influence on prolonged and successful lactation than early contact in the immediate postpartum period.

Timing of postpartum tubal sterilization using the filshie clips: An analysis of data from two developing-country centers

Two-hundred-ninety-seven women at a Panamanian center and 148 women at a Philippine center had their tubal sterilization performed during their postpartum hospital stay after an uncomplicated vaginal delivery of a live birth. The sterilizations were all performed with the use of the Filshie clip via minilaparotomy. The timing of the sterilization varied from two hours to six days after delivery. At each of the two centers, women sterilized within 48 hours after delivery were compared with those sterilized at 49 or more hours with respect to surgical difficulties, tubal injuries, complications/complaints, technical failures and lengths of hospitalization after sterilization and before discharge. The one-year gross cumulative pregnancy rates were also compared. No significant differences were detected in any of the above outcome variables between the two timing groups at each center. While the data suggest that tubal sterilizations by the Filshie clip performed two to six days following childbirth are as safe and effective as those performed within 48 hours of delivery, further studies are urged.

Effects of female sterilization: One year follow-up in a prospective controlled study of psychological and psychiatric outcome

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively ( n = 138) and one year post-operatively ( n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of “normal” postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.

Current concepts in female sterilization.

Current concepts in female sterilization are discussed. Classical methods of postpartum tubal sterilization are not emphasized. Laparoscopic sterilization is a combination of laparoscopy and tubal sterilization. For many years laparoscopic sterilization was handicapped by the little demand for sterilization imperfect equipment and the relatively obscure status of laparoscopy in general in the U.S. In Europe it was more popular. It is a rapid simple and sometimes outpatient procedure. A pneumoperitoneum is created by carbon dioxide insufflation. This allows the bowel to fall away from the operative field permitting the safe introduction of subsequent trocars and leaving a clear view of the pelvis for tubal identification and fulguration. There is a .1% pregnancy rate subsequent to the operation. Complications include pneumoperitoneum problems and trocar insertion problems. The overall complication rate varies from less than 1% to 6%. Vaginal tubal sterilization colpotomy and culdoscopy-colpotomy is becoming an acceptable technique. Transuterine approach to the fallopian tubes may be the answer in bringing about a safe simple female sterilization. Through this approach penetration of the abdominal cavity is avoided. Hysteroscopic tubal cauterization may become a quick simple safe approach to female sterilization but it must first demonstrate its safety and effectiveness. Use of chemosterilants would eliminate instrumentation all together. Quinacrine currently under study has a patency rate of 10% which is unacceptable. Technique refinements may improve results. It is concluded that surgical sterilization is 1 of the best family planning methods today but that in the future transuterine sterilization may become an even safer and more effective method.