Tubal sterilization in an indigent population. Report of fourteen years' experience
Haynes, D.M.; Wolfe, W.M.
American Journal of Obstetrics and Gynecology 106(7): 1044-1053
1970
ISSN/ISBN: 0002-9378 PMID: 5435656 Document Number: 469127
Clinical data on 790 women who underwent tubal sterilization over a 14 year period (1955-1968) were analyzed. Incidence was 2.1 percent of all deliveries. Median age was 29, median parity was seven. Indications were multiparity, previous caesarean section and socioeconomic reasons. All patients were at high risk of subsequent gynecologic disease. Most operations were performed during the puerpurium and a number were done at the time of caesarean section. Standard and modified Pomeroy and Madlener techniques were used as well as Uchida, Irving and some atypical techniques. Among the 489 patients who were followed longer than 3 1/2 years there were 10 failures of the operation, most of them following Madlener type operations, and 178 patients underwent some form of gynecologic operative procedure, 63 of whom required total hysterectomy. Fifteen patients developed carcinoma of the cervix, two died. This study as well as data reviewed in the literature are used to support hysterectomy as the method of choice for sterilization rather than caesarean section and tubal ligation in patients who are at high risk of subsequent gynecologic disease, in general, and of carcinoma of the cervix, in particular, and who require abdominal delivery.