Villela HCM, Pérez RS, Velázquez PAT, Sahagún FJE

Language: Spanish
References: 8
Page: 172-174
PDF size: 210.05 Kb.

ABSTRACT

Tubal sterilization by the Essure device is the most popular contraceptive method worldwide currently approved by the FDA in 2002. It is an alternative to irreversible sterilization. The pregnancy after tubal sterilization with Essure device is rare, reaching 99.8% security. There have been reports of pregnancy in the short term; however we found no cases in the medical literature related to long-term. Our purpose is to present to the medical community a case of pregnancy after three years with this method, and to review the literature. This paper reports the case of a 31 year-old female patient who had a spontaneous pregnancy after a bilateral tubal obstruction with hysteroscopic Essure. An iterative caesarean section was performed at 32.3 weeks of gestation due to severe oligohydramnios and placenta accrete. As a result drilling myometrium was observed with Essure device near the left ostium, and a right Essure device in the correct place. Uterine perforation caused by Essure device placed in proximity to the openings of the tubes can simulate the proper placement of the device, leading to unplanned pregnancies after a long-term placement. The risk can be reduced with strict monitoring protocol, performing a urine pregnancy test on the day of the procedure and instruct patients to follow-up visits.

REFERENCES

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