Transcervical Sterilization
- Essure
o Insertion of small flexible agents through the vagina and cervix the fallopian tubes
o Resulting in the
... [Show More] development of scar tissue in the tubes preventing conception
o Examination must be done within 3 months to ensure fallopian tubes are blocked
- Instruction
o Normal activities may be resumed by most clients with 1 day of the procedure
- Advantages
o Quick procedure that requires no general anesthesia
o Essure is 99.8% effective in preventing pregnancy
o Rapid return to normal activities of daily living
- Disadvantages
o Not reversible
o Not intended for use in the client who is postpartum
o Delay in effectiveness for 3 months
▪ Alternative birth control is needed
o Change in menstrual patterns
- Risk
o Perforation can occur
o Unwanted pregnancy can occur within the first 3 months after procedure
o Increased risk of ectopic pregnancy if pregnancy occurs
Surgical Methods
- Female sterilization
o Severance or burning or blocking the fallopian tubes to prevent fertilization
- Procedure
o The cutting, burning or blocking of the fallopian tubes to prevent the ovum from being fertilized by the sperm
- Advantages
o Permanent contraception
- Disadvantages
o Complications, infection, hemorrhage or trauma
o Considered irreversible if a client desires conception
- Risk
o Ectopic pregnancy if pregnancy occurs
Vasectomy
- Male sterilization
o Ligation and severance of the vas deferens
- Procedure
o Cutting of the vas deferens in the male as a form of permanent sterilization
▪ Use alternative form of birth control for approximately 20 ejaculations or 1 week to several months to allow all of the sperm to clear
▪ This will ensure complete male infertility
- Client instruction
o Use scrotal support and moderate activity for a couple of days
o Sterility is delayed until the proximal portion of the vas deferens is clear or all remaining sperm (20 ejaculations)
o Alternate form of birth control must be used until the vas deferens is cleared of sperm
o Follow up is important for sperm count
- Advantages
o Permanent contraceptive method
o Procedure is short, safe and simple
- Disadvantages
o Requires surgery
o Considered irreversible
- Risk
o Complications are rare
▪ Bleeding, infection and anesthesia reaction
Infertility
- Inability to conceive despite engaging in unprotected sexual intercourse for a prolonged period or at least 12 months
- Diagnostic procedures
o Semen analysis (40%)
▪ This is the first test ran in an infertility workup (less expensive)
▪ May need to be repeated
o Pelvic examination
▪ Assess for uterine or vaginal anomality’s
o Hysterosalpingography
▪ Radiological procedure in which dye is used to assess the patency of the fallopian tubes
▪ Assess for allergies to iodine and seafood
o Hysteroscopy
▪ Uterus is examined for signs of defect, distortion or scar tissue that may impair successful impregnation
▪ Assess for allergies to iodine and seafood
o Laparoscopy
▪ Gas insufflation under general anesthesia is used to observe internal organs
Normal changes during pregnancy
- Signs of pregnancy
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