Twelve-year retrospective review of unintended pregnancies after Essure sterilization in the Netherlands
| Autor: | Sebastiaan Veersema, Michel P. H. Vleugels, Emilie Hitzerd, Henk W.R. Schreuder |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors medicine.medical_treatment Population Essure 03 medical and health sciences 0302 clinical medicine Obstetrics and gynaecology Salpingectomy Obstetrics and Gynaecology medicine Journal Article Humans 030212 general & internal medicine education Netherlands Retrospective Studies Pregnancy education.field_of_study 030219 obstetrics & reproductive medicine Obstetrics business.industry Sterilization Reproductive Infant Newborn Pregnancy Unplanned Obstetrics and Gynecology Retrospective cohort study sterilization medicine.disease failure Multicenter Study Sterilization (medicine) Reproductive Medicine Family planning Female pregnancy business unintended Follow-Up Studies |
| Zdroj: | Fertility and Sterility, 105(4), 932. Elsevier Inc. |
| ISSN: | 0015-0282 |
| Popis: | Objective To identify factors contributing to the occurrence of unintended pregnancies after Essure sterilization in the Netherlands. Even though Essure is a permanent method of contraception, unintended pregnancies have been reported. Design Retrospective case series analysis. Setting Not applicable. Patient(s) Thirty-five pregnancies were reported in the Netherlands after Essure sterilization from 2002 through 2014 out of 27,346 placements. Intervention(s) Data regarding Essure placement procedure, confirmation tests, and pregnancy outcome of the reported cases were obtained and analyzed to identify a possible cause of failure. Main Outcome Measure(s) Four causes of failure were identified: perforation (n = 10), expulsion (n = 7), unilateral placement (n = 7), and luteal pregnancy (n = 2). Result(s) The occurrence of most pregnancies was related to physician noncompliance (n = 14). The other cases were associated with patient noncompliance (n = 5) or misinterpretation of the confirmation test (n = 9). Most pregnancies occurred within the first 24 months after the 3-month confirmation test (n = 23). Conclusion(s) The results of this study show that the incidence of pregnancies after Essure sterilization is low. Most pregnancies were related to incorrect positioning of a device or unilateral placement, and seem therefore preventable. Unilateral placement without prior history of salpingectomy should always be considered as unsuccessful sterilization. Furthermore, interpretation of the confirmation tests should be done by trained physicians, and with caution. We want to emphasize the importance of strictly adhering to placement and follow-up protocols. |
| Databáze: | OpenAIRE |
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