DOCTOR'S VIEW ARCHIVE

Ectopic Pregnancy Risk After Tubal Sterilization

The fallopian tubes normally serve as transport passages for the egg (ovum) to meet the male sperm cell for fertilization. The fertilized egg then implants within the womb (uterus) to establish the developing embryo.

An ectopic pregnancy is a pregnancy that involves implantation of the fertilized egg outside of the uterus. The vast majority of ectopic pregnancies occur in the fallopian tube (95%). However, they can occur in other locations, such as the ovary, cervix, and abdominal cavity. Ectopic pregnancy can be dangerous and even fatal.

Sterilization by interrupting the fallopian tubes (tubal sterilization) is a common method of birth control (contraception). There are a variety of techniques available for tubal sterilization ranging from removing the tubes to clipping or tying (ligation), or electrically burning the tubes closed (coagulation).

Although pregnancy after tubal sterilization is not common, it can occur and may be ectopic.

In a report in the New England Journal of Medicine (1997;336:762-7), Herbert B. Peterson M.D. and associates reviewed the outcome histories of over 10,000 women who had undergone tubal sterilization.

Dr. Peterson's study found that while ectopic pregnancy after tubal sterilization is not common, it is also not rare. Many of the ectopic pregnancies occurred years after the sterilization procedure. They also occurred more frequently in women who had undergone the sterilization procedure before the age 30 years and in those who had histories of inflamed fallopian tubes (pelvic inflammatory disease).

The authors concluded that all women undergoing the tubal sterilization procedure should be aware that ectopic pregnancy can occur many years after sterilization.

Women who have had tubal sterilization and are not aware of this could be at risk for delayed medical care of an ectopic pregnancy. The consequences of this delay include serious internal bleeding, infections in the abdomen and pelvis, and even death.

Symptoms of an ectopic pregnancy can often be vague, and include vaginal bleeding, abdominal or pelvic pain (usually stronger on one side), shoulder pain, weakness, or dizziness. These symptoms can also occur in other conditions such as ovarian cysts. Weakness, dizziness, and a sense of passing out upon standing can represent serious internal bleeding, thus requiring immediate medical attention.

For more information, please visit the Ectopic Pregnancy Center of MedicineNet.com.


Last Editorial Review: 7/25/2002




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