Getting your tubes tied (the popular expression) and tubal ligation (the medical term) actually refer to the same process! Tubal ligation is generally considered a permanent form of pregnancy prevention, or sterilization, for people assigned female at birth. The tubes in question refer to the fallopian tubes, which are a set of thin tubes that transport eggs from the ovaries to the uterus during ovulation. If an egg and a sperm meet in the fallopian tube, fertilization can occur. A fertilized egg then travels to the uterus, where it imbeds itself on the uterine wall and may develop as a pregnancy. Tubal ligation is a procedure that cuts, ties off, or blocks the fallopian tubes in order to prevent an egg and sperm from meeting. To your question about hormonal imbalance as a result of the procedure, recent research suggests that tubal ligations don’t have a significant impact on reproductive hormones (more on that later).

Division of Reproductive and Developmental Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK

In this review the authors recognise the growing contribution of obesity to problems in obstetrics and gynaecology. They then focus on methods to reduce complications in intrapartum and gynaecological care particularly in relation to operating on the obese woman. Strategies to reduce surgical morbidity are discussed including consideration of the site of incision, asepsis and reduction in postoperative complications.

Striae gravidarum are a common finding in the abdominal skin of pregnant women. This study of 128 pregnant women examined factors which are associated with their occurrence. It is clear that women with higher body mass indices have more striae and that striae are also more common in younger women. These findings may be explained by the greater degrees of stretch applied to the skin in obese women with larger babies, and by changes in skin collagen and connective tissue that are age-related and affect its tendency to tear.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 110, Issue 1 p. 87-87 Somalis in Sweden: are bigger babies better? W. A. Liston, W. A. Liston Simpson Memorial Maternity Pavilion, Edinburgh, UKSearch for more papers by this author W. A. Liston, W. A. Liston Simpson Memorial Maternity Pavilion, Edinburgh, UKSearch for more papers by this author First published: 22 December 2003 https://doi.org/10.1046/j.1471-0528.2003.01013.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Essen B, Johnsdotter S, Houelius B, et al. Qualitative study of pregnancy and childbirth experiences in Sweden. Br J Obstet Gynaecol 2000; 106: 1507– 1512. 2 Rush D. Nutrition and maternal mortality in the developing world. Am J Clin Nutr 2000; 72(Suppl): 2125– 2405. 3 Parrish KM, Holt VL, Easterling TR, Connell FA, Logerfo JP. Effect of changes in maternal age parity and birth weight distribution on primary caesarean delivery rates. JAMA 1994; 271: 443– 447. Volume110, Issue1January 2003Pages 87-87 ReferencesRelatedInformation

On October 12, 2000, the destroyer USS Cole was anchored in a foreign port and was severely damaged by explosives in a small craft adjacent to the ship at the port side waterline. Seventeen crew members were killed in the incident. The wounded were evacuated to several medical facilities for their initial care and then to the military hospital in Landstuhl, Germany, and subsequently to the Charette Health Care Center (Naval Medical Center) in Portsmouth, Virginia. There were 35 surviving patients who had sustained 81 total injuries associated with the explosion. The distribution of the injuries included orthopedic, ophthalmologic, soft tissue, otolaryngologic, burns, inhalation, and other miscellaneous injuries. Twenty-seven of the patients were discharged after 24-hour observation. This article reviews the distribution of injuries found in the fatalities and the wounded crew members and the subsequent care required to prepare the military medical community for potential future incidents of this type.

"'Classical' caesarean section at or near term in the morbidly obese obstetric patient." Journal of Obstetrics and Gynaecology, 22(6), p. 691

Recurrent miscarriage is associated with low concentrations of mannan-binding lectin (MBL), but it is not known below which value relative MBL deficiency becomes a significant risk factor. The sera of 397 patients (male and female) suffering from recurrent miscarriage and 376 controls were assayed for MBL and the data analysed. It was found that the lower the cut-off value, the greater the statistical strength of the association. It was concluded that only MBL concentrations </=0.1 microg/ml were clinically significant in this context. A corollary of this conclusion is that genotyping for point mutations in the structural gene for MBL would be a much less sensitive means of identifying couples at risk of experiencing recurrent miscarriage.

OBJECTIVE:To ascertain the views of general practitioners (GPs) about screening for cystic fibrosis. To find out whether and under what conditions they might play a part in the delivery of such programmes.SETTING:All GP practices within the Lothian Health Board area.METHODS:A self administered questionnaire was sent to each of the 532 GPs in the area.RESULTS:334 (63%) GPs participated in the study. Only 23% of these claimed to have no professional or personal experience of the disorder. 77% of GPs were aware of the existence of a programme of antenatal screening for cystic fibrosis (CF), which had been running in Edinburgh for the past six years, with only 2% unfavourably disposed to it. However, when asked to rank CF screening against antenatal screening for spina bifida and Down's syndrome, or cervical and breast screening, 55% gave it the lowest priority. There was fairly equal support for the screening site being an antenatal clinic, a genetic centre, a family planning clinic, or a GP surgery, but little enthusiasm for programmes in schools or the workplace. Surprisingly, only 13% of GPs thought that screening should be offered to those with a negative family history of the disorder. Although the idea of involvement in screening was favoured, GPs claimed that any aspect of delivery that they undertook would need to be supported. There were no significant differences between the responses of fundholding GPs and non-fundholders.CONCLUSIONS:The low ranking by GPs of CF screening against other programmes, together with the need for support if they were to be involved, suggests that it is currently impractical to move the programme from its existing site in antenatal clinics.

Pregnancy-induced hypertension may be regarded as a manifestation of endothelial-cell dysfunction. The role of the eNOS gene in the development of a familial pregnancy-induced hypertension was evaluated by analysis of linkage among affected sisters and in multiplex families (n = 50). Markers from a 4-cM region encoding the eNOS gene showed distortion from the expected allele sharing among affected sisters (P = .001-.05), and the statistic obtained from the multilocus application of the affected-pedigree-member method also showed distortion (T-[f(P=sqrt(P)]) = 3.53; P < .001). A LOD score of 3.36 was obtained for D7S505 when a best-fitting model derived from genetic epidemiological data was used, and LOD scores of 2.54-4.03 were obtained when various other genetic models were used. Estimates of recombination rate, rather than maximum LOD-score values, were affected by changes in the genetic parameters. The transmission-disequilibrium test, a model-free estimate of linkage, showed strongest association and linkage with a microsatellite within intron 13 of the eNOS gene (P = .005). These results support the localization of a familial pregnancy-induced hypertension-susceptibility locus in the region of chromosome 7q36 encoding the eNOS gene.

Mannan binding protein (MBP) may be important for host defence particularly in infancy. MBP concentration was measured in 237 umbilical cord blood samples from singleton pregnancies and compared to those of 352 blood donors. Both data sets yielded a bimodal frequency distribution, consisting of a log-normal peak and a long tail of lower values. The range (0-23 U/ml) and median (7.2 U/ml) of cord blood values were significantly lower than those of blood donors (range 0-43 U/ml; median 8.3 U/ml). MBP was also measured in the cord blood samples of 8 pairs of twin siblings. Discordant values in two pairs of twins suggest that cord blood MBP is derived from the fetoplacental unit and not from the maternal circulation by transplacental passage.

A comparative study of women who underwent prenatal cystic fibrosis (CF) carrier screening by either the 'two-step method' or the 'couple method' was carried out 2-4 years after testing. Recall of the screening test and test result, understanding of the implications of the test result, and reproductive intentions and behaviour were compared. Women screened by the two-step method were significantly better informed on the genetic implications of the test result and the significance of being a single gene carrier than their couple screen counterparts. Regardless of the method of screening, a majority of those who had received a negative test result erroneously believed that they were definitely not a carrier. However, women who intended having further children were significantly more likely to understand correctly that a negative test result meant that they were unlikely to be a CF carrier. The method of testing had no influence on reproductive intentions or behaviour. Differences in emphasis, content and presentation of pre-screening information and counselling between the two methods of screening are identified. Reasons for variation in the long-term understanding between women screened by the two methods are discussed. (C) 1997 by John Wiley & Sons, Ltd.

A retrospective study was carried out of the cases of positive syphilis serology detected by routine antenatal screening within Edinburgh (and surrounding district) over the six years 1988 to 1994. The study demonstrated a low incidence of syphilis with only 15 pregnancies in 58,445 screened, In eight cases serology and history were suggestive of late latent syphilis and in the remainder of previous infection which had been treated, Ail women were delivered of liveborn infants at term without stigmata of congenital syphilis, Lack of identifiable risk factors in women with positive serology suggests that routine rather than selective screening should continue.

Sir, It was with great interest that we read the study by Fleming and Hull (Vol 103, March 1996)’ suggesting that the presence of a hydrosalpinx significantly reduces the chance of embryo implantation following IVF. The authors therefore proposed that women with hydrosalpinges undergo distal salpingostomy or salpingectomy . We quite agree with the authors that salpingectomy would be preferable to salpingostomy as “it would not only remove the source of the fluid from the hydrosalpinx, but would much reduce the risk of ectopic pregnancy”’; moreover, a fairly high number of tubes will probably undergo re-occlusion as suggested by the relatively low pregnancy rates following salpingostomy, whether performed by microsurgery or laparoscopically, even in the most experienced We wonder, though, whether a laparoscopic proximal tubal occlusion (with clips, diathermy, etc.) would not be a better choice than either salpingostomy or salpingectomy. This procedure is technically easier and faster (in particular as a fair number of these cases will have pelvic adhesions) and thus has a lower morbidity. Proximal tubal occlusion will have a higher success rate in preventing tubal fluid from draining into the uterus and, as is the case with salpingectomy, the risk of ectopic pregnancy is greatly reduced.

PURPOSE: This study was undertaken to examine the long-term results of medical and surgical management for diverticulitis. METHODS: A retrospective review of all patients admitted to Naval Medical Center Portsmouth, Virginia, between January 1991 and February 1994, was conducted. Of 78 patients included in the study, 65 were able to be contacted for follow-up. RESULTS: The surgically treated group consisted of 33 patients, and medically treated group had 32 patients. Of the medically treated group, 62.5 percent were found to have continuing symptoms. Medically treated patients with a long history and infrequent flares tended to be less symptomatic after hospitalization. Conversely, those medical patients with a short intense history were more likely to have symptoms. The frequency of symptoms in the surgical group was surprising, because 27.2 percent of this group reported continuing symptoms. CONCLUSIONS: Close follow-up of medically treated patients for objective evidence of diverticulitis is indicated. When surgical therapy is undertaken, patients should be counseled that symptoms may be largely unchanged following operation.

The distribution of mannan binding protein (MBP) in blood donor sera was determined by enzyme-linked immunosorbent assay to establish normal concentrations. Abnormally low MBP concentrations were found in 16% (21 out of 135) of female partners and 14% (15 out of 108) of male partners of couples experiencing recurrent miscarriage, compared with < 5% of obstetrically normal controls (P < 0.005). This relationship was even stronger (9.5 versus 1.0%) and more significant (P < 0.002) when only subjects presumed to be homozygous for the mutant allele responsible for MBP deficiency were considered. By immunohistochemistry, MBP could be demonstrated in first trimester placenta. We suggest that low concentrations of MBP within the feto-placental unit increase susceptibility to fetal loss, possibly via an infection-induced placental cytokine imbalance.