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  • Title: Tubal pregnancy following application of tantalum clips at culdoscopy for sterilization.
    Author: Neuwirth RS, Casthely S, Kim YH.
    Journal: Am J Obstet Gynecol; 1972 Dec 15; 114(8):1066-8. PubMed ID: 4635201.
    Abstract:
    In 1971, a 30-year-old woman underwent a culdoscopic tubal ligation with the application of tantalum clips. She was healthy on first examination and 3 weeks after the operation. Procedure included local anesthesia, meperidine and diazepam analgesia, Weck-Gutierrez clamp for delivering the fallopian tubes, and Weck Hemo-clips applied to the mid ampullae. The patient failed to appear for hysterosalpingogram after her first menses, but returned for abdominal complaint 7 months later. Eleven months after the operation she reported with 5 weeks of amenorrhea, followed 3 days later by cramps and bleeding. Pelvic exam, culdocentesis, and laparoscopy showed a mass in the left fimbria. Pathology revealed a slit lumen on the left, and flat epithelium, attenuated muscle layer bilaterally. The failure to obtain hysterosalpingography and to reveal incomplete occlusion of the tube in this case suggest a need for meticulous follow-up care. The role of epithelium and of muscularis in pregnancy is unclear.
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