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Pregnancy After Tubal Ligation
The U.S. Collaborative Review of Sterilization (CREST) found the failure rate for tubal ligation (all occlusion methods) to be 1.85% after 10 years [1].
Of the sterilization failures in CREST, one third were ectopic pregnancies (not within the uterus)[2].
Because of the high rate of ectopic pregnancy, women of child bearing age who have had tubal sterilization should have a pregnancy test performed if they have not had a menstrual period. If the woman is pregnant,
then she should be evaluated further for the presence of an ectopic pregnancy.
Symptoms and Signs of Possible Ectopic Pregnancy
| Symptoms | Signs |
| Abdominal pain | Adnexal tenderness |
| Missed menstrual period |
Abdominal tenderness |
| Vaginal bleeding | Adnexal Mass |
| Dizziness or fainting |
Uterine enlargement |
| Shoulder pain | Orthostatic changes |
| Urge to defecate | Fever |
| Pregnancy symptoms | |
| Passage of tissue | |
In the absence of complicating maternal conditions a pregnancy found to be within the uterus after tubal ligation (without a coexisting tubal pregnancy) would not be expected to be at increased risk for miscarriage or fetal abnormality.
REFERENCES
1. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization.
Am J Obstet Gynecol. 1996;174:1161-8
MEDLINE
2. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J.
The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group.
N Engl J Med. 1997;336:762-7.
MEDLINE
Created: 11/2/2002
Update: 12/21/2002
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