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Dr. Andrew Rynne

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Have had tubal ligation. Missing periods and started spotting. HPT negative. Worrisome

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
I had a tubal ligation 5 years ago (2007) and just recently missed period in October and only had light brown discharge with some light pink discharge for 2-3 days. It was only when I wiped. I do not have pms symptoms but have some pregnancy symptoms. I took a test but it came back negative. I am really worried what this means. Should I be worried over this? I do feel some fullness almost bloating but nothing serious. In July I passed to be what was called a uterine cast? I need to know if pregnancy is possible as I am on pain pills due to surgery. I have had dizziness, light headedness , odd sinus type headache, and very tired. I am not a hypochondriac :) so I would prefer to find out as much as possible before going to my doctor.
Answered by Dr. Sudhir 2 hours later

Thanks for the question.

Tubal ligation failures are documented to have occurred, but the percentage of failure is quiet low. So you should be evaluated for both pregnancy and other causes of delayed/missed periods. Your current symptoms are not specific for pregnancy.

Urine pregnancy tests are good, but may not be always correct.

Ideal next step would be to get sonography and if needed serum HCG tests done. This will help to know about pregnancy status as well as cause of delayed periods. Get the tests done sooner, so that you can decide about your medications.

A prior consultation with your gynecologist will prove helpful.

Hope this answers your question. Please feel free to ask if there are doubts.

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Follow-up: Have had tubal ligation. Missing periods and started spotting. HPT negative. Worrisome 6 hours later
What is the failure rate of this? I was assured it was something that would prevent pregnancy. I had a rough go the last pregnancy and thought this would be the safest alternative for me. If it were to be a pregnancy what would be my options? I see that etopic is a concern? I would not have even pondered pregnancy however my body is telling me otherwise. I took another test and got a very faint positive this morning. I am really concerned over this
Answered by Dr. Sudhir 15 minutes later

Thanks again for following up.

The failure rate of tubal ligation is approximately 2-10/per 1,000 women.

A faint line is suggestive of pregnancy. However to be very sure, you should get serum HCG levels checked. It is more reliable and definitive way to know that you are pregnant or not.

And yes, you are at risk to develop ectopic pregnancy. An ultrasonography can help us to rule out ectopic pregnancy. Treatment would probably involve a surgery if it is indeed an ectopic.

Hope for the best... Get the tests done.
I will be available for further assistance.

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Follow-up: Have had tubal ligation. Missing periods and started spotting. HPT negative. Worrisome 8 days later
I went to the doctor and had my blood taken, I am indeed pregnant and the baby is in the uterus. I am still in awe over the whole thing. Will the medications I have taken be a concern, I have stopped everything and hoping this will be good enough. I did not know I was pregnant or I would not have had surgery, or taken medications. I wish I would have been better informed of the risks. I do not understand if they grew back together or how that happens..I had gallbladder surgery in XXXXXXX 2012, could the surgery maybe stirred up my insides lol :).... thank you for all your help.
Answered by Dr. Sudhir 1 hour later

Thanks for follow up.

Gall bladder surgery is unlikely to have any connection with this, because in such surgery surgeon doesn't go inside beyond region of gall bladder.So there is no question of touching your uterus or tubes.(Just for your info)

There is no way now to tell how the tube/s got recanalized.

In initial stage of pregnancy, when embryo is in cellular level(made up of few cells) it might not get affected by medication so drastically as when embryo is in later stage of organ formation.So there are pretty good chances that pregnancy is still fine.

You will to have write down details like - name of medications, days for which you were taking them, when you missed period,when did you test, what is age of baby on sonography, when did you stop taking medications.And show this to your Gynecologist, after studying this doctor can give you a good opinion.

Importantly if at all doctor is not sure, which is very likely to happen - you will have to get multiple sonographies done at various stages of pregnancy to see the baby is fine.

(my wife had similar issues, she took antibiotics, pain medications and was x rayed in first week of pregnancy.For us everything turned out normal.But there were no sure answers till end)

Hope this answers your question.Regards.

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