Shavell Valerie I, Abdallah Mazen E, Shade George H, Diamond Michael P, Berman Jay M
Department of Obstetrics and Gynecology, Wayne State University School of Medicine and the Detroit Medical Center, Detroit, Michigan, USA.
J Minim Invasive Gynecol. 2009 Jan-Feb;16(1):22-7. doi: 10.1016/j.jmig.2008.08.017. Epub 2008 Nov 8.
To investigate trends in sterilization in women at the Detroit Medical Center, Michigan (DMC), since the introduction of Essure hysteroscopic sterilization.
Retrospective study (Canadian Task Force classification II-2).
Outpatient surgery center and university teaching hospitals.
Women who underwent interval sterilization procedures at the DMC (Hutzel Women's Hospital, Sinai-Grace Hospital, and the Berry Center) and postpartum sterilization procedures at Hutzel Women's Hospital between January 1, 2002, and December 31, 2007.
Permanent sterilization procedures including minilaparotomy tubal ligation, laparoscopic sterilization, Essure hysteroscopic sterilization, and postpartum tubal ligation performed at the time of cesarean section or after vaginal delivery.
In all, 5509 permanent sterilization procedures were performed in the 6 years between January 1, 2002, and December 31, 2007, at the DMC facilities analyzed: 2484 interval sterilization procedures at Hutzel Women's Hospital, Sinai-Grace Hospital, and the Berry Center, and 3025 postpartum tubal ligations at Hutzel Women's Hospital. From 2002 through 2007, the decrease in laparoscopic sterilizations from 97.9% to 48.5% of all interval sterilization procedures corresponded significantly with the increase in Essure hysteroscopic sterilizations from 0.0% to 51.3% (p <.001). Postpartum tubal ligations performed after vaginal delivery also decreased significantly during the study period from 7.9% to 3.3% of all vaginal deliveries (p <.001) while the percentage of tubal ligations performed at the time of cesarean section remained constant (p =.051).
At the DMC facilities analyzed from January 1, 2002, through December 31, 2007, a significant decrease occurred in the percentage of laparoscopic sterilizations and postpartum tubal ligations performed after vaginal delivery. Of the interval sterilizations performed, the percentage of Essure hysteroscopic sterilizations increased significantly from 0.0% to 51.3% of all procedures. Since the approval of Essure hysteroscopic sterilization in November 2002, this minimally invasive method of hysteroscopic sterilization has increased in popularity at the DMC.
调查自引入依思珠宫腔镜绝育术以来，密歇根州底特律医疗中心（DMC）女性绝育手术的趋势。
回顾性研究（加拿大工作组分类II-2）。
门诊手术中心和大学教学医院。
2002年1月1日至2007年12月31日期间在DMC（哈策尔妇女医院、西奈-格雷斯医院和贝里中心）接受非孕期绝育手术以及在哈策尔妇女医院接受产后绝育手术的女性。
永久性绝育手术，包括小切口输卵管结扎术、腹腔镜绝育术、依思珠宫腔镜绝育术以及剖宫产时或阴道分娩后进行的产后输卵管结扎术。
在分析的DMC机构中，2002年1月1日至2007年的6年间共进行了5509例永久性绝育手术：哈策尔妇女医院、西奈-格雷斯医院和贝里中心进行了2484例非孕期绝育手术，哈策尔妇女医院进行了3025例产后输卵管结扎术。从2002年到2007年，腹腔镜绝育术在所有非孕期绝育手术中的占比从97.9%降至48.5%，这与依思珠宫腔镜绝育术从0.0%增至51.3%显著相关（p<.001）。研究期间，阴道分娩后进行的产后输卵管结扎术在所有阴道分娩中的占比也从7.9%显著降至3.3%（p<.001），而剖宫产时进行输卵管结扎术的比例保持不变（p = 0.051）。
在分析的2002年1月1日至2007年12月31日期间的DMC机构中，腹腔镜绝育术和阴道分娩后产后输卵管结扎术的比例显著下降。在进行的非孕期绝育手术中，依思珠宫腔镜绝育术在所有手术中的占比从0.0%显著增至51.3%。自2002年11月依思珠宫腔镜绝育术获批以来，这种微创的宫腔镜绝育方法在DMC越来越受欢迎。
