GENERAL LAPAROTOMY RISKS
Any surgery which involves the opening of the abdomen has risks. The risks of anesthesia alone are small, but real. There is always a possibility of infection, sometimes serious. It is possible for the bowel, bladder and other adjacent pelvic structures to be injured in the course of surgery even when performed in a skilled, careful manner.

BLEEDING
Bleeding may be encountered in any surgery and is usually controlled without loss of structure, function or life. Transfusion may be necessary in some circumstances. The TAC procedure involves placing the Mersilene band (polyester band) in an area with abundant blood supply, particularly through a network of veins prone to disruption and rapid bleeding. We encounter some bleeding from these vessels frequently. Control of this bleeding is accomplished via electrocautery (burning), suture ligature (tying off) of the veins and hemoclips (surgical staples).

LOSS OF THIS PREGNANCY
Demise of the fetus(es) can occur as a result of operating on the mother, and through preterm labor initiated by the surgery or the handling of the uterus.

HYSTERECTOMY
If bleeding cannot be controlled by the usual surgical techniques, mass ligature of the entire uterine vascular bundle on one or both sides may be necessary. In an extreme circumstance, hysterectomy may be necessary.

RISKS OF CESAREAN DELIVERY
After the cervix has been closed by TAC, any fetus of greater than about 14 weeks gestation will need to be delivered by opening the uterus (cesarean). Thus, any of the risks associated with cesarean apply to a pregnancy in a mother who has a TAC in place.

RISK OF UTERINE RUPTURE
If labor is allowed to progress in a mother with TAC in place, the obstruction to the uterine outlet could result in rupture of the cervix or uterus. This could generate a substantial risk to the woman's life, but often is managed by cesarean delivery and/or hysterectomy.

IMPONDERABLES
Although we have encountered relatively few complications of TAC, clinical medicine is not without risks. Sometimes, unexpected complications arise and must be dealt with according to the problems they present. Birth defects have not been associated with this procedure, although we expect ALL pregnancies to have an incidence of 3-5% of birth defects identified in the newborn.