title: Indications for removal of etonogestrel implant within two years of use in Jos, Nigeria.
abstract: BACKGROUND
  Implanon is a new long-term and reversible sub-dermal contraceptive implant in Nigeria. It is a single rod containing 68mg of etonogestrel meant to offer contraception for three years and marketed by Organon.
  
  
  OBJECTIVE
  To determine the indications for removal of Implanon rods from clients within a two-year period.
  
  
  METHODS
  A retrospective review of 30 consecutive Implanon removals within the study period.
  
  
  METHODS
  The fertility regulation unit of the department of obstetrics and gynaecology of the Jos University Teaching Hospital, North-Central Nigeria.
  
  
  RESULTS
  A total of 30 clients requested for and had their Implanon rods removed out of 669 insertions constituting 95.5% crude continuation rate in the second year. The clients were of mean age 31.4 +/- 6.2 years, mean parity 2.9 +/- 1.8 and mean number of living children 2.7 +/- 1.6. There was an average weight gain of 1.9 kg. The most common indication for removal was menstrual disruption (33.3%). Desire for another pregnancy closely followed (30.0%). Weight gain was another indication for discontinuation (13.3%). Two women were pregnant at insertion of the implant. There was one failure of the method with pregnancy as a result. Spousal disapproval was an indication for removal in two cases.
  
  
  CONCLUSIONS
  Like all progestin-only contraceptive methods, menstrual disruption was the most common indication for removal of implants. Inadvertent insertion of implants with existing pregnancy is of concern and should be avoided as much as is possible. In doubtful cases at insertion, this insertion should be deferred or serum beta-HCG should be assessed to exclude chemical pregnancy.
authors: Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
authors: J T
authors: JT
authors: Mutihir
authors: D D
authors: DD
authors: Nyango
mesh_terms: D000328:Adult; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use*; D017135:Desogestrel / Q000009:adverse effects / Q000627:therapeutic use*; D020878:Device Removal; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008599:Menstruation Disturbances / Q000139:chemically induced*; D008875:Middle Aged; D009549:Nigeria; D011247:Pregnancy; D019736:Prostheses and Implants; D043762:Reproductive Behavior; D012189:Retrospective Studies; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; C044815:etonogestrel; D017135:Desogestrel