Cost-effectiveness of opportunistic salpingectomy vs tubal ligation at the time of cesarean delivery
American Journal of Obstetrics and Gynecology Sep 04, 2018
Venkatesh KK, et al. - A cost-effectiveness analysis was performed to compare the strategies for long-term sterilization and ovarian cancer risk reduction at the time of cesarean delivery, including bilateral tubal ligation, opportunistic salpingectomy, and long-acting reversible contraception (LARC). In this theoretic cohort study, researchers included 110,000 pregnant women desiring permanent sterilization at the time of cesarean delivery and ovarian cancer prevention at an average of 35 years who were monitored for an additional 40 years based on an average US female life expectancy of 75 years. Outcomes revealed that for permanent sterilization and ovarian cancer risk reduction, both bilateral tubal ligation and bilateral opportunistic salpingectomy with cesarean delivery were cost-effective strategies. On threshold analyses, they identified the necessity for better ascertaining the risks and benefits of salpingectomy with cesarean delivery before determining a preferred strategy although salpingectomy and tubal ligation are both reasonable strategies for cesarean patients seeking permanent sterilization and cancer risk reduction.
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