What is the effectiveness of titanium clips compared with partial salpingectomy for postpartum tubal sterilization?

Updated: Jun 18, 2018
  • Author: Nan G O'Connell, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

The Filshie clip system is an alternative to partial salpingectomy in the postpartum setting, particularly useful in difficult surgical cases (eg, obesity, intra-abdominal adhesions). [6, 7] A randomized controlled trial published in 2012 showed, however, that the titanium clip was not as effective as partial salpingectomy in the postpartum setting. [8] Through 2 years of observation, the pregnancy probability for the clip group was 0.017 compared with 0.004 for the partial salpingectomy group (= 0.04). However, this study was limited by a high loss–to–follow-up rate (just over 50% for both groups) and a limited follow-up period (24 mo). [8] Increased edema and hypertrophy of the fallopian tubes in pregnancy are thought to be responsible for this difference in effectiveness.


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