[Intrapartum and interval tubal sterilization].
BACKGROUND
Brazil is a country with a high prevalence of tubal ligation, which is frequently performed at the time of delivery. In recent years, an increase in tubal reversal has been noticed, primarily among young women.


OBJECTIVE
To study characteristics correlated with the procedure, determine frequency of intrapartum tubal ligation, measure patient satisfaction rates and tubal sterilization regret, in a sample of post-tubal patients.


METHODS
Three hundred and thirty-five women underwent tubal ligation. The variables studied were related to the procedure: age at tubal ligation, whether ligation was performed intrapartum (vaginal or cesarean section) or after an interval (other than the intrapartum and puerperal period), health service performing the sterilization, medical expenses paid for the procedure, reason stated for choosing the method and causes related to satisfaction/regret: desire to become pregnant after sterilization, search for treatment and performance of tubal ligation reversal. The women were divided into two groups, a group undergoing ligation in the intrapartum period and a second group ligated after an interval, to evaluate the association between variables by using Fisher's exact test and chi-squared calculation with Yates' correction. The study was approved by the Ethics Committee of the institution.


RESULTS
There was a predominance of Caucasian women over 35 years of age, married, and with a low level of education of which 43.5% had undergone sterilization before 30 years of age. Two hundred and forty-five women underwent intrapartum tubal ligation, 91.2% of them had cesarean delivery and 44.6% vaginal delivery. In both groups undergoing intrapartum tubal ligation and ligation after an interval, 82.0% and 80.8% reported satisfaction with the method. Although 14.6% expressed a desire to become pregnant at some time after sterilization, consultation regarding sterility occurred in 3.4% and 2.3%, respectively, and one woman underwent tubal reversal. The most frequent reasons for choosing the method were satisfaction with the number of offspring (35.5% and 46.7%) and medical indication (41.6% and 32.2%), respectively.


CONCLUSIONS
The incidence of intrapartum tubal ligation was higher when the last delivery had been a cesarean section. No difference was detected among the groups regarding rates of satisfaction and regret after performance of the sterilization procedure.
Fernandes
Arlete Maria Dos Santos
AM
Area de Tocoginecologia, Faculdade de Ciências Médicas, Pontifícia Universidade Católica de Campinas. arlete@fcm.unicamp.br
Bedone
Aloísio José
AJ
Leme
Larissa Capochin Paes
LC
Yamada
Elza Mitiko
EM
D000328:Adult; D000367:Age Factors; D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004644:Emotions; D005191:Family Characteristics; D005260:Female; D006801:Humans; D036801:Parturition; D010549:Personal Satisfaction; D049590:Postpartum Period; D012959:Socioeconomic Factors; D013243:Sterilization Reversal / Q000523:psychology / Q000706:statistics & numerical data*; D013246:Sterilization, Tubal / Q000523:psychology / Q000706:statistics & numerical data*