Sterilization: No end to ectopics

Sterilization does not eliminate the risk of ectopic pregnancy, even years after the procedure; the highest risks are among women who have undergone bipolar coagulation and those sterilized before age 30.1 Among 10,685 U. S. women who were sterilized between 1978 and 1986, 47 ectopic pregnancies occurred within 10 years after the operation. The 10-year cumulative probability of ectopic pregnancy was 7.3 per 1,000 procedures overall; it ranged from 1.5 per 1,000 for women who had had a postpartum partial salpingectomy to 17.1 per 1,000 for those who had undergone bipolar coagulation. Women sterilized before age 30 were twice as likely as those sterilized at older ages to have an ectopic pregnancy; for younger women, the probability varied substantially according to method (from 1.2 per 1,000 for postpartum partial salpingectomy to 31.9 per 1,000 for bipolar coagulation). The annual rate of ectopic pregnancies did not decline over time. Thus, the researchers emphasize, women considering sterilization "should be informed that ectopic pregnancy may occur long after sterilization"; furthermore, health care providers should not discount the possibility of ectopic pregnancy in a woman who has been sterilized but has symptoms or signs suggesting pregnancy.

1. H. B. Peterson et al., "The Risk of Ectopic Pregnancy After Tubal Sterilization," New England Journal of Medicine, 336:762-767, 1997

Copyright The Alan Guttmacher Institute May/Jun 1997
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