title: Norplant insertions at the Zeynep Kamil Gynecologic and Pediatric Training Research Hospital in Istanbul.
abstract: OBJECTIVE
  This study was conducted to determine sociodemographic characteristics and usage interval according to insertion period, observed side effects and reasons for discontinuation in 756 cases where Norplant was inserted and removed for any reasons at our hospital since 1994.
  
  
  METHODS
  Seven-hundred and fifty-six cases in whom Norplant was inserted and removed since 1994 were included in our study. Sociodemographic characteristics, former contraception method, reasons for choosing this method and side effects seen during the usage period were determined. In all cases, reasons for discontinuation, sociodemographic characteristics and usage interval according to the insertion period were investigated. Statistical analysis of this study was performed with SPSS 9.0 (analysis of variance).
  
  
  RESULTS
  Mean age of cases was 26.5 +/- 4.9 years, mean number of living children was 2.0 +/- 1.2, and 50.4% of cases had no health insurance. Most of the cases used coitus interruptus previously as a contraceptive method and chose Norplant use because of its effectiveness. Insertion periods were as follows: interval, n = 513 (67.9%); postpartum, n = 127 (16.8%) and postabortion, n = 116 (15.3%). Various side effects were detected in 79.8% of the cases. Bleeding problems were seen in 69.8%. Pregnancy occurred in only one case. Mean Norplant usage interval was 3.08 +/- 1.68 years. The longer usage interval was seen in cases with lower educational level. When we compared the usage intervals between interval, postpartum and postabortion periods, we found that the interval group had a shorter mean duration of Norplant use. Discontinuation because of bleeding problems occurred in 38.1%. Removal of all Norplant implants was performed at a single session in 731 cases (96.4%). After Norplant removal, most cases selected either condom or IUD as the contraceptive method.
  
  
  CONCLUSIONS
  It is concluded that despite the frequent occurrence of side effects, Norplant is a modern, long-acting, highly effective, reversible, easy-to-use, satisfactory form of birth control, especially in selected cases.
authors.affiliation: Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Gyneacology Dep., Istanbul, Turkey. astugrul@ixir.com
authors.forename: Semih
authors.initials: S
authors.lastname: Tugrul
authors.forename: Bekir
authors.initials: B
authors.lastname: Yavuzer
authors.forename: Arif
authors.initials: A
authors.lastname: Kayahan
authors.forename: Gazi
authors.initials: G
authors.lastname: Yildirim
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000600:supply & distribution*; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016912:Levonorgestrel / Q000009:adverse effects / Q000600:supply & distribution*; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D018873:Pregnancy Rate; D012959:Socioeconomic Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel