Signs of ectopic pregnancy include missed menstrual periods, reduced menstrual flow, fainting, or lower abdominal pain. While female sterilization is generally very safe, rare fatalities or long-term injuries occur due to surgery. About five per 100,000 sterilized women die in developing countries. The primary causes of death are cardiac or respiratory arrest resulting from anesthesia problems or unintended injury during surgery. In a retrospective study examining female sterilization services in 50 countries from 1973 to 1988, general anesthesia was found to be the most common cause of sterilization-related mortality, followed closely by deaths from intestinal injuries and deaths from infection.
Local anesthesia minimizes the potential for complications.
However, local anesthesia is not appropriate for all women. Some women are allergic to local anesthetics, and obese women typically require general anesthesia because the operation is more difficult to perform on them. The increased use of local anesthesia and improved infection control in many countries during the 1980s significantly reduced fatality rates associated with sterilization. Other improvements have included the establishment of safe upper limits of the dose for common anesthetics, better ways to monitor vital signs, and increased training in the management of cardiorespiratory depression. However, local anesthesia can also involve complications.