A Retrospective Study: Performing Opportunistic Salpingectomy at Time of Cesarean at a Community Residency Program [21B]

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Abstract

INTRODUCTION:

The American College of Obstetricians and Gynecologists (ACOG) supports discussing opportunistic salpingectomy at the time of pre-operative counseling period for benign gynecologic surgery. Cesarean section is the most common procedure an obstetrician-gynecologist performs in the United States; however, little data exists regarding performing opportunistic salpingectomies at the time of cesarean delivery. This retrospective study sought to evaluate the safety of performing an opportunistic salpingectomy at the time of cesarean section.

METHODS:

A total of 56 patients with singleton intrauterine pregnancy >37 weeks gestational age undergoing a scheduled cesarean at St. Vincent Women’s Hospital were identified from January 1, 2015 to August 1, 2017. Data was abstracted from electronic medical records. Estimated blood loss (EBL), length of operating room (OR) time, differences in hemoglobin pre and post-operatively, and return to operating room within 30 days were analyzed. Other data abstracted included age, body mass index, gravidity/parity, pregnancy complications (e.g., diabetes), training level of surgeon, and surgical technique.

RESULTS:

The average drop in hemoglobin was 1.25 g/dL. Average EBL was 745cc. The most common method was using a Ligasure device, followed by traditional clamp, cut, and tie. One patient required transfusion postoperatively for hemoglobin of 6.7 g/dL. Average OR time was 99.5 minutes. No patients returned to the OR for complications related to surgery.

CONCLUSION:

Performing bilateral salpingectomy at the time of cesarean section appears to be safe. Physicians performing cesarean sections should offer opportunistic salpingectomies to women at average-risk for developing ovarian cancer.

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