Abstract
Objectives
To identify the frequency and characteristics associated with total salpingectomy
(TS) versus occlusion or partial salpingectomy (PS) at the time of cesarean delivery.
Study design
We performed a retrospective chart review of cesarean deliveries with a concurrent
permanent contraception procedure, from July 1, 2014 to June 30, 2019 at 2 hospitals
(community hospital and tertiary care academic center) within a single healthcare
system. We assessed the proportion of TS versus PS at cesarean, and secondarily compared
operative times between the 2 procedures.
Results
We identified 2110 procedures during the 5-year period. Surgeons performed TS in 302
(14%, 95% confidence interval [CI] 13%–16%) cases, and the annual rate varied from
14% to 18% over the study period (p = 0.14). Factors associated with increased likelihood of TS rather than PS included
public insurance/self-pay (adjusted odds ratio, aOR 2.8, 95% CI 2.0–4.1), delivery
at the community hospital (aOR 4.8, 95% CI 3.0–7.7), parity of 5 or more (aOR 2.2,
95% CI 1.1–4.4), and presence of an obstetrician/gynecologist for cesarean delivery
(aOR 2.9, 95% CI 1.6–5.4). The total operative time for TS and PS differed at the
academic center (90 vs 68 minutes, p < 0.001) but not at the community hospital (55 vs 54 minutes, p = 0.5).
Conclusions
This study highlights provider and institutional characteristics associated with TS
compared to PS at the time of cesarean delivery, which may inform future programs
aimed at increasing utilization of TS at cesarean delivery.
Implications
Access to TS at the time of cesarean delivery may provide pregnant women with a very
effective permanent contraception method at a convenient time of concurrent cesarean.
This study identifies patient factors that may influence access to TS as part of obstetrical
care.
Keywords
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Article info
Publication history
Published online: December 16, 2020
Accepted:
December 4,
2020
Received in revised form:
November 29,
2020
Received:
June 28,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
