FEMALE STERILISATION THROUGH MINI-LAPAROTOMY AT GONDAR COLLEGE OF MEDICAL SCIENCES
Abstract
Objectives: To describe the socio-demographic characteristics and clinical course and
follow up of clients who have undergone voluntary surgical contraception (VSC) through
minilaparotomy (mini-lap) under local anaesthesia (LA). Also, to evaluate the safety and
method satisfaction, so as to forward recommendations for method utilisation in the
Ethiopian context.
Design: A case series design where pre- and post-operative conditions of clients coming for
voluntary surgical contraception via mini-laparotomy were systematically analysed.
Setting: Department of Obstetrics and Gynaecology, Gondar C:ollege of Medical Science!;,
Gondar, Ethiopia.
Subjectsand methods: Eighty two clients (median ageof 33 years, range25 - 40) who decide(d
to use tubal sterilisation method of contraception from April 1993 to May 1995 were
included in the study. A format prepared and distributed to VSC providing sites i~a
Ethiopia by the Family Guidance Association of Ethiopia (FGAE) was used in co1lectin;g
the necessary information, including informed consent of every client.
Main outcome measures: Previous knowledge of contraceptive methods, decision making
for tubal sterilisation, size of incision, advantages of use of local anaesthesia in the local
setting, duration of hospital stay, conditions on follow up.
Results: Eighty two (55.4%) wonien underwent tubal sterilisation through mini-lap. The
mean number of the live children per client was 6.2k1.7, with parity ranging from two to
eleven children. Mothers with five or more children were 70 (85.4%). Among 69 mother!;
(84.1. %), the last pregnancy o~~tcome were live births. The average length of the time sincc:
making a decision not to have any more children was 2.32 years (median of one year). Thc:
rationales given were econonlic, ill health and completed family size. Regarding the pattern,
of decision making, in 77 (91.9 %)clients both the couples wereinvolved in decision making.
All except two underwent the procedure under LA and no complication was encountered
during surgery. Follow-up attendance was 100% in one-year period and nothing serious
was reported. All reported to be satisfied with the method.
Conclusion: The study showed that early decision making by involving both couples other
than proper case selection miriimises regrets. The authors believe that tubal sterilisation
through mini-lap under LA is an ideal method in developing countries where access to
family planning and other reproductive health services are not widely available and where
there is population explosion, less than 10% contraceptive prevalence rate and high
maternal mortality.
follow up of clients who have undergone voluntary surgical contraception (VSC) through
minilaparotomy (mini-lap) under local anaesthesia (LA). Also, to evaluate the safety and
method satisfaction, so as to forward recommendations for method utilisation in the
Ethiopian context.
Design: A case series design where pre- and post-operative conditions of clients coming for
voluntary surgical contraception via mini-laparotomy were systematically analysed.
Setting: Department of Obstetrics and Gynaecology, Gondar C:ollege of Medical Science!;,
Gondar, Ethiopia.
Subjectsand methods: Eighty two clients (median ageof 33 years, range25 - 40) who decide(d
to use tubal sterilisation method of contraception from April 1993 to May 1995 were
included in the study. A format prepared and distributed to VSC providing sites i~a
Ethiopia by the Family Guidance Association of Ethiopia (FGAE) was used in co1lectin;g
the necessary information, including informed consent of every client.
Main outcome measures: Previous knowledge of contraceptive methods, decision making
for tubal sterilisation, size of incision, advantages of use of local anaesthesia in the local
setting, duration of hospital stay, conditions on follow up.
Results: Eighty two (55.4%) wonien underwent tubal sterilisation through mini-lap. The
mean number of the live children per client was 6.2k1.7, with parity ranging from two to
eleven children. Mothers with five or more children were 70 (85.4%). Among 69 mother!;
(84.1. %), the last pregnancy o~~tcome were live births. The average length of the time sincc:
making a decision not to have any more children was 2.32 years (median of one year). Thc:
rationales given were econonlic, ill health and completed family size. Regarding the pattern,
of decision making, in 77 (91.9 %)clients both the couples wereinvolved in decision making.
All except two underwent the procedure under LA and no complication was encountered
during surgery. Follow-up attendance was 100% in one-year period and nothing serious
was reported. All reported to be satisfied with the method.
Conclusion: The study showed that early decision making by involving both couples other
than proper case selection miriimises regrets. The authors believe that tubal sterilisation
through mini-lap under LA is an ideal method in developing countries where access to
family planning and other reproductive health services are not widely available and where
there is population explosion, less than 10% contraceptive prevalence rate and high
maternal mortality.
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