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Puerperal tubal sterilizations were performed on 1,830 women in the department of obstetrics of the Johns Hopkins Hospital between June 1, 1936, and Dec. 31, 1950. Table 1 lists the indications for sterilization; the most common were: (1) great multiparity only, 33.3%; (2) chronic hypertension and/or repeated toxemia, 17.7%; and (3) repeat cesarean section, 15.4%. As used in the clinic and in this paper, the term "great multiparity" is defined rigidly as eight or more previous viable deliveries (each fetus weighing over 1,000 gm.). The number eight was used since maternal mortality has been thought to rise sharply after the eighth delivery1; and, because of this fact, we have hitherto believed that great multiparity, so defined, is truly a medical indication. One-third of all the sterilizations here reported were done solely on this indication. In addition to this group, 161 women presented not only great multiparity but also had
JAMA – American Medical Association
Published: Jun 11, 1955
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