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Risk of ectopic pregnancy following tubectomy.


 83 cases of ectopic pregnancy were analyzed at the All India Institute of Medical Sciences from January 1976-December 1980. 8 of the women, aged 26-42, had had a tubectomy performed 9 months to 8 years earlier and of these 1 had had recanalization 4 years after the tubectomy which resulted in an ectopic pregnancy 1 year later. 5 cases had had Pomeroy's technique, 1 a vaginal tubectomy, 1 a laparoscopic fulguration, and 1 a Yoon's ring. It has been observed that the ectopic pregnancy may occur more often following sterilization because the recanalized oviduct or granuloma may be so narrow that it may allow the sperm to pass but may not allow the fertilized ovum to cross. The incidence of ectopic pregnancy in the general population is 1.25% to .34% and the rate of ectopic pregnancy following tubectomy failure has been reported to be 5.3%. So the relative risk for having an ectopic pregnancy in women who conceive as a result of tubectomy failure can be estimated to be 4-16 times higher. Increasing acceptance of female sterilization and use of laparoscopy may also increase the number of ectopic pregnancies and cause a rise in mortality for 1st trimester deaths.
