Comparison of Two Salpingectomy Techniques for Sterilization at the Time of Cesarean Delivery

NCT ID: NCT06273683

Last Updated: 2025-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

900 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-03-11

Study Completion Date

2025-12-31

Brief Summary

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One in three women of reproductive age utilize tubal sterilization for contraception, and sterilization is often requested at time of cesarean delivery. Complete salpingectomy for the purpose of permanent sterilization at the time of cesarean birth is increasingly being performed worldwide.

A preferred complete salpingectomy technique for the purpose of sterilization at the time of cesarean delivery has not emerged in current practice. The objective is to compare short-term clinical outcomes and cost of salpingectomy using a hand-held bipolar energy instrument with those of traditional suture ligation. This retrospective cohort study will be conducted from 2017-2023 at a single tertiary care hospital. The investigators hypothesize that bipolar energy instrument use will not significantly improve clinical outcomes.

Detailed Description

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Conditions

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Permanent Sterilization Pregnancy Related

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Complete salpingectomy using a hand-held bipolar energy instrument

Hand-held bipolar energy instrument

Intervention Type OTHER

A bipolar energy instrument is used for complete salpingectomy at the time of cesarean delivery.

Complete salpingectomy using traditional suture ligation

Traditional suture ligation

Intervention Type OTHER

Traditional suture ligation technique is used for complete salpingectomy at the time of cesarean delivery.

Interventions

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Hand-held bipolar energy instrument

A bipolar energy instrument is used for complete salpingectomy at the time of cesarean delivery.

Intervention Type OTHER

Traditional suture ligation

Traditional suture ligation technique is used for complete salpingectomy at the time of cesarean delivery.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* request for permanent sterilization at the time of cesarean delivery
* 24 weeks' gestation or beyond
* 21 years old or older
* Medicaid sterilization consent per Virginia Department of Medical Assistance Services regulations (if Medicaid recipient).

Exclusion Criteria

* vaginal delivery
* history of prior adnexal surgery (such as prior bilateral tubal ligation or unilateral salpingectomy oophorectomy)
* placenta accreta spectrum
* placenta previa
* history of bleeding diathesis.
Minimum Eligible Age

21 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Inova Health Care Services

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean W Thermolice, MD

Role: PRINCIPAL_INVESTIGATOR

Inova Fairfax Medical Campus

Locations

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Inova Fairfax Medical campus

Falls Church, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jean W Thermolice, MD

Role: CONTACT

703-531-3000

Bianca Nguyen, MD

Role: CONTACT

512-750-9573

Facility Contacts

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Jean W Thermolice, MD

Role: primary

703-531-3000

Bianca Nguyen, MD

Role: backup

References

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Mandelbaum RS, Matsuzaki S, Sangara RN, Klar M, Matsushima K, Roman LD, Paulson RJ, Wright JD, Matsuo K. Paradigm shift from tubal ligation to opportunistic salpingectomy at cesarean delivery in the United States. Am J Obstet Gynecol. 2021 Oct;225(4):399.e1-399.e32. doi: 10.1016/j.ajog.2021.06.074. Epub 2021 Jun 26.

Reference Type BACKGROUND
PMID: 34181896 (View on PubMed)

Venkatesh KK, Clark LH, Stamilio DM. Cost-effectiveness of opportunistic salpingectomy vs tubal ligation at the time of cesarean delivery. Am J Obstet Gynecol. 2019 Jan;220(1):106.e1-106.e10. doi: 10.1016/j.ajog.2018.08.032. Epub 2018 Aug 28.

Reference Type BACKGROUND
PMID: 30170036 (View on PubMed)

Subramaniam A, Einerson BD, Blanchard CT, Erickson BK, Szychowski J, Leath CA 3rd, Biggio JR, Huh WK. The cost-effectiveness of opportunistic salpingectomy versus standard tubal ligation at the time of cesarean delivery for ovarian cancer risk reduction. Gynecol Oncol. 2019 Jan;152(1):127-132. doi: 10.1016/j.ygyno.2018.11.009. Epub 2018 Nov 23.

Reference Type BACKGROUND
PMID: 30477808 (View on PubMed)

ACOG Committee Opinion No. 774 Summary: Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention. Obstet Gynecol. 2019 Apr;133(4):842-843. doi: 10.1097/AOG.0000000000003165.

Reference Type BACKGROUND
PMID: 30913193 (View on PubMed)

Society of Gynecologic Oncology. SGO Clinical Practice Statement: Salpingectomy for Ovarian Cancer. 2013. https://www.sgo.org/clinicalpractice/guidelines/sgo-clinical-practice-statement-salpingectomy-for-ovarian-cancer-prevention

Reference Type BACKGROUND

Walker JL, Powell CB, Chen LM, Carter J, Bae Jump VL, Parker LP, Borowsky ME, Gibb RK. Society of Gynecologic Oncology recommendations for the prevention of ovarian cancer. Cancer. 2015 Jul 1;121(13):2108-20. doi: 10.1002/cncr.29321. Epub 2015 Mar 27.

Reference Type BACKGROUND
PMID: 25820366 (View on PubMed)

Nguyen, N. T., Alabaster, A., Simmons, S., Weintraub, M. L. R., & Powell, C. B. (2019). Opportunistic salpingectomy techniques at the time of cesarean delivery: a retrospective cohort study. Journal of Clinical Gynecology and Obstetrics, 8(3), 70-76.

Reference Type BACKGROUND

Lauterbach R, Gruenwald O, Matanes E, Justman N, Mor O, Vitner D, Avrahami R, Ghanem N, Zipori Y, Weiner Z, Lowenstein L. A randomized controlled trial of 2 techniques of salpingectomy during cesarean delivery. Am J Obstet Gynecol MFM. 2022 Nov;4(6):100690. doi: 10.1016/j.ajogmf.2022.100690. Epub 2022 Jul 16.

Reference Type BACKGROUND
PMID: 35843545 (View on PubMed)

Chan LM, Westhoff CL. Tubal sterilization trends in the United States. Fertil Steril. 2010 Jun;94(1):1-6. doi: 10.1016/j.fertnstert.2010.03.029.

Reference Type RESULT
PMID: 20497790 (View on PubMed)

Other Identifiers

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INOVA-2023-145

Identifier Type: -

Identifier Source: org_study_id

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