ABSTRACT
PIP: This study presents information about the postpartum sterilization program of a teaching hospital in Nuevo Leon, Mexico, and compares results to data reported in the literature. 147 patients undergoing sterilization between February-August 1984 were included. 6 of the women were under 20 years old, 18 were 21-25, 63 were 26-30, 30 were 31-35, and 30 were 36 or over. 22 had had 1-3 children, 81 had 4-6, 27 had 7-9, and 17 had over 9. 96.6% were married. 92 had never used a contraceptive method, 47 had used pills, 7 had used IUDs, and 1 had used a barrier method. Only 29 had been born in the Nuevo Leon metropolitan area but 126 were current residents. 101 had incomplete or complete primary educations, 8 had secondary educations, 36 were illiterate, and 2 had professional educations. Only 38 had prenatal health care preceding the delivery. Hemoglobin levels in 20 cases were less than 9.0, 28 were 9.1-10.0, 45 were 10.1-11.0, 34 were 11.1-12.0, and 20 were 12.1 or above. 17.6% of patients required preoperative transfusions of packed blood. The indication for sterilization was multiparity in 96.6% of cases. 13 patients had epidural anesthesia during delivery, 1 had a subarachnoid block, and 133 had no anesthesia. 139 had epidural blocks during the sterilization operation, 6 had subarachnoid blocks, and 2 had general anesthesia. There was 1 case of cardiorespiratory arrest but recovery was satisfactory. The only obstetric complication was 1 perforation of the jejunum, which was repaired. There were no other cases of pre- or postoperative complications except for 21 cases of difficulty in providing epidural anesthesia. The Pomeroy technique was used in 139 sterilizations, fimbriectomy in 5, and salpingectomy in 5. Umbilical hernioplasties were done in 3 patients without complications. The interval between surgery and leaving the hospital was between 12-24 hours in 83.7% of cases. The interval between delivery and sterilization was 12-24 hours in 71.4% of cases. Only 9 cases required more than 4 days of hospitalization. The immediate postpartum is not considered the optimal moment for female sterilization because of the increased vulnerability of the patient. The experience with this series suggests that for some patients, tubal sterilization by minilaparotomy in the immediate postpartum is a valuable method because it meets the demand for definitive contraception among high parity women of low socioeconomic level and with limited access to medical care. It requires only brief hospitalization and involves very low rates of morbidity.^ieng
