High failure rate of a plastic tubal (Bleier) clip

Sixteen intrauterine pregnancies (8.6%) have been documented among 187 women who had undergone direct placement of American-made Bleier clips for sterilization. Of these, five pregnancies (10.2%) followed clip placement in 49 cesarean deliveries, nine pregnancies (8.2%) followed 110 infraumbilical postpartum procedures, and two pregnancies (7.1%) occurred in 28 interval minilaparotomy patients. Resterilization by tubal segment excision has been performed in five unsuccessful cases. In one case, the excised portions of tube with clips in place were studied by radiologic and histologic methods. Tubal patency may persist if the oviduct is trapped in the catch portion of the clip.