title: The Norplant removal training and service at Dr Kariadi Hospital, Semarang, Indonesia.
abstract: The mean of the Norplant usage period of 338 acceptors was 44.4 months. Most users had poor education and low incomes; the lower their socioeconomic status, the longer they used the Norplant implant. Return to fertility 3 months after removal was 38.46%; after 6 months, 71.43%; after 9 months, 74.46%; and after 12 months, 75%. The continuation rate at year one was 82.84%; year 2, 74.85%; year 3, 68.34%; year 4, 64.79%; while year 5 was 8.58%. The mean removal time was 21 minutes. There was a very significant difference between trained and untrained removers in the duration of removal. The average number of capsules removed was 5.64. There was no significant difference between trained and untrained removers in successful capsule removal. Reasons for removal were expired date and non-medical complaints such as changing to other contraceptives and the wish to become pregnant; medical complaints were dizziness, vertigo, spotting and amenorrhea. Removal was prompted by acne, metrorrhagia, two or more medical complaints, menorrhagia, physical pain, tenderness at insertion site and spotting. There were no pregnancies found among acceptors. However, 5.92% of the acceptors were pregnant at the time of insertion because of misdiagnosis. It can be concluded that Norplant is effective, safe and acceptable but removal needs trained persons.
authors.affiliation: Department of Obstetrics and Gynecology, Medical Faculty of Diponegoro University, Dr Kariadi Hospital, Semarang, Indonesia.
authors.forename: N P
authors.initials: NP
authors.lastname: Noerpramana
mesh_terms: D000293:Adolescent; D000328:Adult; D004343:Drug Implants; D004522:Educational Status; D005260:Female; D006801:Humans; D007214:Indonesia; D016912:Levonorgestrel / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance; D012959:Socioeconomic Factors
chemical_list: D004343:Drug Implants; D016912:Levonorgestrel