Complications of female sterilization procedure: review over a decade at district tertiary care hospital

Abstract

Background: Female sterilization is the most requested permanent contraceptive method worldwide and one of the most frequently performed elective, intra-abdominal surgical procedure in reproductive-age women. Even though considered as simple and safe procedure, complications do occur including death. Methods: The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization complications and secondary is to evaluate possible etiological factors leading to complications and lay standard guidelines to reduce complication rate. Results: Over a decade, 103 cases of female sterilization related complications were documented, out of 14 cases (13.6%) were of laparoscopic tubal ligation and rest 89 were minilaparotomy (86.4%). In 3 cases tubal ligation was not performed as surgeon was not able to either open peritoneal cavity or find fallopian tubes due to adhesions (2.91%). In 70 cases (67.96%) sterilization were performed in primary health centre (PHC). Four patients (3.88%) required hospital stay of more than a month with longest stay being 43 days. Exploratory laparotomy with surgical intervention was done in 34 cases (33%). Two patients (1.94%) died due to tubectomy complications due to septicemia and encephalitis. Conclusions: Female sterilization is very popular and commonly performed permanent method of sterilization but complications can happen and many of them are preventable with proper screening and selection of cases with proper evaluation before surgery. There is a need to have proper training in sterilization and to stick to standards of sterilization procedure to minimize chances of complications.

Postpartum sterilization: a five years retrospective study

“…12 In a study by Mule et al who also reported 84.6% of complications were of mini-laparotomy whereas in laparoscopic tubal ligation, complications were only 13.4%. 13 Wang et al demonstrated that interval and postpartum laparoscopic sterilization is a safe, simple and quick operation and appears to be superior to postpartum minilaparotomy in terms of complications. 14…”

Effectiveness of a quality improvement intervention to increase adherence to key practices during female sterilization services in Chhattisgarh and Odisha states of India

“…GoI incorporated these directives into the revised quality standards, which also established a quality assurance mechanism and a revised compensation scheme for adverse events, should they occur [ 11 ]. Although this led to some improvements, public sector female sterilization services still did not meet the prescribed quality standards [ 12 , 13 ], resulting in an unacceptable number of deaths, complications, and failures [ 5 , 14 ]. In 2014, a major shift in the discourse around female sterilization took place when 16 women died after undergoing sterilization surgery in a family planning camp in the state of Chhattisgarh.…”