Opportunistic Salpingectomy for Permanent Sterilization at the Time of Cesarean Delivery

Not Applicable

Completed

Interventions: Procedure: Bilateral Salpingectomy
Procedure: Bilateral Tubal Ligation

Brief Summary: The purpose of this study is to compare the safety of performing a bilateral tubal ligation vs. bilateral salpingectomy, two procedures performed for permanent sterilization, at the time of cesarean delivery. The investigators want to determine if performing bilateral salpingectomy at the time of cesarean delivery poses any greater risk for blood loss, as compared to a bilateral tubal ligation.

Detailed Description: A non-inferiority, two-arm randomized controlled trial to evaluate the safety and feasibility of prophylactic salpingectomy at the time of a cesarean delivery will be conducted as an initiative to avoid a missed opportunity in the primary prevention of ovarian cancer. Once enrolled and consented, women will be randomized using a stratified block randomization algorithm according to number of prior cesarean deliveries and BMI to either salpingectomy or bilateral tubal ligation. The data collection will include preoperative CBC, time of procedure, postoperative CBC at 24 hours, standard patient demographics, procedural complications, estimated blood loss, return to the OR, length of stay, pain scores, and postoperative complications, including readmission within 6 weeks.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Salpingectomy	Bilateral Salpingectomy	Bilateral salpingectomy following cesarean delivery
Tubal Ligation	Bilateral Tubal Ligation	Bilateral tubal ligation following cesarean delivery via Parkland or modified Pomeroy methods.

Primary Outcome Measures

Name	Time	Method
Mean Difference Between Pre and Postoperative Hemoglobin (g/dl)	At least 24 but not greater than 48 hours after surgery	Identify the mean difference in pre and postoperative hemoglobin for patients undergoing salpingectomy for sterilization vs. patients undergoing standard bilateral tubal ligation via mid-segment resection of the fallopian tube at the time of cesarean delivery.

Secondary Outcome Measures

Name	Time	Method
Operative Time	Day of surgery	Compare mean difference in length of operative time (in minutes) to perform bilateral salpingectomy as compared to standard bilateral tubal ligation, following cesarean delivery.
Estimated Blood Loss	Day of surgery	Identify mean difference in estimated total blood loss as a result of standard bilateral tubal ligation surgical procedure and bilateral salpingectomy procedure, following cesarean delivery.