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[Surgical sterilization failure: a study of 290 cases].

: This study seeks to establish the failure rate of sterilizations in the Profamilia pilot clinic in Bogota, and analyzes the chronology of the resulting pregnancies and their possible causes and the reactions of the women who became pregnant. 31,828 sterilizations were performed in the clinic between 1973 and 1980, 8% of them minilaparotomies. 272 of 290 pregnancies diagnosed after sterilization were method failures, the other 18 having begun before the operation. Almost 60% of the pregnancies occurred within 1 year of the operation, and all but 4% occurred within 4 years. The rate calculated on the basis of the 1st 12,000 sterilizations, 142 of which were followed by pregnancies due to method failure, was 1.18%, or 1 case per 85 operations. The average age of the women who became pregnant was 31.0 years, compared to the average of 33.4 years for all women undergoing sterilization. Possible reasons for the failures are discussed, including incomplete follow-up, defective materials, surgical skill, and the performance of operations by students. Analyses of 157 cases of reinterventions indicate that 27% of the failures resulted from human error and the rest from method imperfections including incomplete occlusion of the tube, recanalization, and refistulization. 7.35% of the pregnancies were ectopic. 33.8% of the women who became pregnant bore children, 11.7% had spontaneous abortions, and 54.5% sought induced abortions.