Evaluation of post sterilization ectopic gestations

Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation.Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India.Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases.Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy