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Clinical Summary

Salpingectomy at the time of permanent contraception: rates have increased

Takeaway

  • Uptake of salpingectomy at the time of permanent contraception has increased since publication of the American College of Obstetricians and Gynecologists (ACOG) 2015 recommendations.

Why this matters

  • 2015 ACOG Committee Opinion recommends discussion of bilateral salpingectomy at the time of permanent contraception to reduce risks of ovarian cancer.
  • Bilateral salpingectomy increases operative time by 6-10 minutes; complication rates are similar between procedures.
  • Future rates of ovarian cancer may support success of this procedure.

Key results

  • 14.8% underwent salpingectomy for an indication of permanent contraception.
  • Rates of salpingectomy increased over the study period, from <1% in 2013 to 61.5% in 2017.
  • Rates of salpingectomy differed by region and were highest in the Midwest at 16.2% and lowest in the Northeast at 13.1% (P<.0001).
  • Teaching hospitals had higher rates of salpingectomy vs smaller, nonteaching institutions: 15.0% vs 14.2% (P=.0001).
  • Private insurance was linked to higher rates of salpingectomy vs Medicaid: 15.7% vs 14.3% (P<.0001).

Study design

  • Deidentified data from Vizient Clinical Data Base, a database from 50 US health care systems and 160 community hospitals.
  • Included women who underwent a permanent contraception procedure between 2013 and 2017 (n=174,930).
  • ICD codes used to identify type of procedure.
  • Funding: None.

Limitations

  • Coding errors possible.

References


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