Your patient is a 26-year-old G3P2 who desires permanent sterilization following her upcoming delivery. Her past medical and surgical histories are unremarkable. During your counseling session you quote failures rates for puerperal sterilization; you discuss alternative methods of contraception, including the advantages of vasectomy; and you discuss possible operative and anesthesia complications. Which other preoperative counseling points regarding female tubal sterilization are true?
a. Ease of sterilization reversal
b. Higher risk of later menstrual irregularities
c. Choice of either an abdominal or a hysteroscopic approach for puerperal sterilization
Which of the following aspects of normal postpartum maternal anatomy are not advantageous for puerperal sterilization?
b. Lax anterior abdominal wall
c. Engorged mesosalpinx vessels
Outcomes associated with performing puerperal tubal sterilization the morning after vaginal delivery include which of the following?
a. Increases the risk of anesthesia-related complications
b. Provides longer opportunity to assess neonatal well-being
c. Increases the risk of postpartum hemorrhage complicating the postoperative course
Although highly effective and shown here, which method is an uncommonly used technique for puerperal sterilization?
Reproduced with permission from Hoffman BL: Surgeries for benign gynecologic conditions. In Schorge JO, Schaffer JI, Halvorson LM, et al (eds) Williams Gynecology. New York, McGraw-Hill, 2008, Figure 41-24.5.
Sterilization in the puerperium is typically performed using which of the following anesthetic methods?
d. Transversus abdominis plane block