Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Sometimes endometrial tissue passes along with blood clot which can give the appearance you described. If the bleeding is persistent or increases associated with pain you better go to ER. Though you underwent tubectomy, rarely due to failure pregnancy is possible. In that case, you have to exclude abortion. Urine pregnancy test and ultrasound helps in it. If bleeding is normal in quantity like regular menstrual flow, you can wait and consult your gynecologist. Hope I have answered your query and I will be happy to answer any further follow-up queries. Take care.