Safety of postabortion sterilisation compared with interval sterilisation. A controlled study

Abstract

406 women--about one-fifth of those requesting an induced abortion and sterilisation over a thirty-three-month period--volunteered to be allocated randomly to either a concurrent induced-abortion/sterilisation group or a group which was sterilised six weeks after abortion. The abortion-attributable and sterilisation-attributable complication rates of 3.8% and 5.2%, respectively, for the concurrent group did not differ significantly from the 6.7% and 6.9% rates for the interval group. The estimated 2%-10% of women who would have changed their minds must be set against the 4% of women who became pregnant again before being sterilised. Efforts should be made to identify women likely to regret sterilisation.

PIP: In order to determine the optimal time for performing sterilizations on women requesting both abortion and sterilization, a prospective, comparative study of 406 women, who agreed to be randomly allocated to either a postabortion or an interval sterilization group, was undertaken at the Kandang Kerbau Hospital in Singapore. The combined immediate and delayed complication rate for the interval groups was higher than for the postabortion group, but the difference was not significant. Among the women in the interval group, 6.7% had complications stemming from the abortion and 6.8% had complications attributable to the sterilization procedure. For the postabortion sterilization group, the respective rates were 3.8% and 5.2%. Initially 195 women were allocated to the interval abortion group, but 64 of these women changed their minds and did not keep their sterilization appointments. 51 of these 64 women were contacted from 3 months to 3 years later, and 20 of the women, at last contact, still did not want to be sterilized. Given this data, the investigators estimated that 2-10% of the women who undergo postabortion sterilization can be expected to regret their decision. On the other hand, women electing interval sterilization have a 4% risk of becoming pregnant before the sterilization is performed. There were no sterilization failures reported in the study. The postabortion and interval groups were comparable in terms of age, parity, and gestation duration prior to abortion. Tables included 1) distribution by age, family size, ethnic affliation, and gestation duration for postabortion and interval groups and for those women who did not appear for their interval sterilization appointments; and 2) distribution of types of complications associated with abortion and sterilization for both the interval and the postabortion groups.