How are complications of postpartum tubal sterilization prevented?

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

Answer

Complications of minilaparotomy are typically minor, including wound infection and incisional hernia formation. To avoid the minor wound infection that may occur following surgery, a thorough preoperative skin preparation with an antiseptic solution must be performed. There is no indication for preoperative antibiotic prophylaxis for the procedure.

To decrease the risks associated with difficulty in locating abdominopelvic structures, the surgeon must assess the level of the fundus before the start of the procedure to ensure the adnexa is adequately accessible.

Failure rates at 12 months poststerilization and major morbidity are rare. [1] A common reason for sterilization failure is ligation of the wrong structure, typically the round ligament. Therefore, careful identification and isolation of the fallopian tube before ligation is necessary. Furthermore, if a tubal segment is excised, pathologic confirmation is an important step, when available.

Poststerilization regret is very age-dependent, with 20% of women aged 30 years or younger regretting their decision, whereas only 6% of those older than 30 years express regret. [9] Any ambivalence displayed by a patient in the peripartum period should be considered an indication to delay the sterilization procedure. However, a retrospective study by Thurman and Janecek reported that women who requested postpartum tubal sterilization but did not receive it were more likely to become pregnant again within 1 year than women who did not request sterilization. [10]


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