title: Complications and risk factors associated with the removal of Norplant implants.
abstract: OBJECTIVE
  To describe the complications reported at the removal of Norplant implants, and to suggest potential risk factors for these complications.
  
  
  METHODS
  Complications at the removal of Norplant implants from 3416 users from 11 countries who participated in preintroductory clinical trials of the method were tabulated. A logistic regression model was used to identify the significant risk factors associated with removal complications.
  
  
  RESULTS
  Complications were reported in 4.5% of removals; most often, they were related to broken or deeply placed implants. The most important risk factors were complications at insertion and having an infection at the implant site (at or before removal).
  
  
  CONCLUSIONS
  Proper insertion technique under aseptic conditions is very important in predicting whether Norplant implant removal will be difficult. Although relatively infrequent even now, more vigilant training and the evaluation of some of the newer removal techniques could further reduce the incidence of difficult removals.
authors.affiliation: Family Health International, Research Triangle Park, North Carolina.
authors.forename: T R
authors.initials: TR
authors.lastname: Dunson
authors.forename: R N
authors.initials: RN
authors.lastname: Amatya
authors.forename: S L
authors.initials: SL
authors.lastname: Krueger
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D004343:Drug Implants; D005260:Female; D006801:Humans; D015994:Incidence; D016912:Levonorgestrel; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012044:Regression Analysis; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors
chemical_list: D004343:Drug Implants; D016912:Levonorgestrel