Pregnancy after Tubal Sterilization

Objectives: In our study, we have tried to evaluate the causative factors for sterilization failure and also to discuss preventive measures to avoid maternal morbidities and unwanted pregnancies and as a result of sterilization failure especially in developing countries like India and tried to establish methods to decrease the rates of failed sterilization. Materials and Methods: This study is a retrospective study that was done on all the women presented with failed sterilization in the Department of obstetrics and gynaecology, GSL medical college and general hospital from May 2018 to May 2019. Results: During 1 year 20 cases of post-sterilization failure were reported, out of which 16 (80%) cases were intra-uterine pregnancies and 4 (20%) were ectopic pregnancies. Among which 17 (85%) cases underwent sterilization by modified Pomeroy’s method & 3(15%) underwent laparoscopic sterilization.14 (70%) cases presented to opd within 12 wks of gestation, out of which 2 cases (10%) underwent first trimester MTP.10 (50%)cases delivered at term by normal vaginal delivery, 1case delivered as preterm & 4 (20%) delivered at term by elective cesarean section. 7 cases underwent resterilisation by fimbriectomy & 13 cases underwent sterilization by bilateral salpingectomy. Conclusion: In the present study open method of sterilization was the most common cause of post sterilization failure than laparoscopic sterilization. Conversely, sterilization failure after one year is more likely due to natural tubal lumen regeneration through tubal recanalization or fistula formation. Hence proper counselling before sterilization should be done regarding the procedure, failure rates and morbidity. Surgical procedures should document Intra-operative adhesions, difficulty in identifying tubes, slipped rings or bands. Despite few failure rates tubal sterilization remains the most chosen method to control the population.