A comparison between puerperal and nonpuerperal laparoscopic sterilization.

Of 237 patients selected for laparoscopic sterilization 167 were postpartum (average age 30 parity 7) and 70 were interval sterilizations (average age 29 parity 6). Indications were multiparity or medical. The puerperal patients were operated on between the first and seventh day postpartum the majority on day 2-4. General anesthesia with endotracheal intubation was used after premedication. Spinal anesthetic was used for 5 patients. Techniques of Palmer Frangenheim and Steptoe were used except that tenacula were not placed on the cervices of puerperal patients. The most frequent anesthetic complication was hypotension. This can be avoided by infusing the patients with lactated ringers solution before insufflation with gas. Minor operative complications were urinary tract infections fever and a protruding omentum. Hysterosalpingography was discontinued later in the study. There were two subsequent pregnancies. One was pregnant at the time of operation and the other had the round ligament coagulated.