A review of bilateral tubal ligation at caesarean section in Jos, Nigeria

Abstract

Context: The advent of minilaparotomy under local anaesthesia has revolutionalised the performance of bilateral tubal ligation for permanent contraception in Jos. Female sterilisation has however continued to be performed during caesarean section mainly for obstetric or surgical reasons.

Objective: To determine the incidence of bilateral tubal ligation during caesarean section, and the trend over the years in Jos, Nigeria.

Methodology: This was a retrospective analysis of the register of all bilateral tubal ligations including those performed at caesarean section, between January 1985 and December 2000 (16 years).

Results: A total of 3,585 female sterilisations were performed, and 533 (14.9%) were at caesarean section. The rest were through minilaparotomy under local anaesthesia (84.3%) and laparoscopy (0.7). The yearly rate of tubal ligation at caesarean section declined from 33.8% in 1985 to 16.3% in 2000. The commonest indication for the tubal ligation during caesarean section was repeat caesarean section, and accounted for 55.5%. The mean age and parity of the women were 32.1 years and 5.0 respectively. The mean of the number of children of the women at the time of the caesarean section was 4.5. There was a significant difference in age, parity and number of living children of the women compared with those that had bilateral tubal ligation at times other than during caesarean section. There was no complication specific to the tubal ligation at caesarean section.

Conclusion: About 15% of all female sterilisations were performed at caesarean section. The trend demonstrated a decline, probably influenced by the advent of minilaparotomy under local anaesthesia in Jos, Nigeria.