title: Continuation of the etonogestrel implant in women undergoing immediate postabortion placement.
abstract: OBJECTIVE
  To estimate whether women who receive an immediate postabortion etonogestrel subdermal implant have higher discontinuation rates than women who undergo an interval insertion (insertion not associated with a recent pregnancy).
  
  
  METHODS
  This was a secondary analysis of the Contraceptive CHOICE Project. We compared 12-month continuation rates for the subdermal implant between women undergoing immediate postabortion placement and women who underwent an interval placement. Continuation rates were compared using Kaplan-Meier estimator of survival function and Cox proportional hazard models.
  
  
  RESULTS
  Over the study period, 141 women received the implant immediately postabortion and 935 women underwent an interval placement. The 12-month continuation rates were similar: 81.5% among women undergoing immediate postabortion placement and 82.8% among women undergoing interval placement (P=.54). In the survival analysis, women who received an immediate postabortion implant were no more likely to discontinue their method than women who had an interval placement (adjusted hazard ratio 1.04, 95% confidence interval 0.68-1.60). The most common reason given for discontinuation was frequent or irregular bleeding, which was reported by 65.4% of women discontinuing in the immediate postabortion group and 56.7% in the interval group.
  
  
  CONCLUSIONS
  Women who undergo immediate postabortion placement of the subdermal implant have high rates of continuation that are equivalent to women undergoing interval insertion. Immediate postabortion long-acting reversible contraceptives should be available to women undergoing induced abortion to decrease the risk of repeat unplanned pregnancy.
  
  
  METHODS
  II.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110, USA. maddent@wustl.edu
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
authors.forename: David L
authors.initials: DL
authors.lastname: Eisenberg
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zhao
authors.forename: Christina
authors.initials: C
authors.lastname: Buckel
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017135:Desogestrel / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000139:chemically induced; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; C044815:etonogestrel; D017135:Desogestrel