Safety and Benefits of Contraceptives Implants: A Systematic Review

Rocca, Morena; Palumbo, A.; Visconti, Federica; Carlo, Costantino Di

doi:10.3390/ph14060548

Cited by 36 publications

(22 citation statements)

References 200 publications

(397 reference statements)

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“… 39 , 40 Using it for the recommended time without discontinuation has significant importance in minimizing unwanted pregnancies, unsafe abortions, and related adverse health outcomes on maternal and child health. 41 For myriad reasons, users discontinue using Implanon while they still desire to prevent pregnancy. 17 Its premature discontinuation implies poor quality of FP services provision.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of Implanon discontinuation and associated factors among Ethiopian women: A systematic review and meta-analysis

Habte¹,

Tamene²,

Woldeyohannes³

et al. 2022

Womens Health (Lond Engl)

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Background: Implanon discontinuation before the recommended time is problematic, as it puts women at risk of unwanted pregnancies and unsafe abortions, along with negative maternal health outcomes. Although the magnitude and determinants of Implanon discontinuation have been studied in Ethiopia, the results were inconsistent, with significant variability. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of Implanon discontinuation and its determinants in Ethiopia. Methods: A comprehensive search of studies published before 18 February 2022 was done using electronic databases such as PubMed, Embase, Google Scholar, Scopus, Web of Science, Science Direct, and Cochrane Library. The relevant data were extracted using a Microsoft Excel 2013 and analyzed using STATA Version 16. A random-effect meta-analysis model was used to compute pooled prevalence and odds ratio. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg’s, and Egger’s tests were used to check for the presence of publication bias. Results: A total of 11 studies with 4320 study participants were included in this meta-analysis. The overall pooled prevalence of Implanon discontinuation in Ethiopia was found to be 32.62% (95% confidence interval = 24.10, 41.13). There was significant heterogeneity among the included studies ( I2 = 97.4%, p < 0.001). However, there was no statistical evidence of publication bias ( p = 0.533). Dissatisfied with service provision at the time of insertion (odds ratio = 3.92, 95% confidence interval = 1.54, 6.29), not having pre-insertion counseling (odds ratio = 2.98, 95% confidence interval = 1.91, 5.04), the absence of post-insertion follow-up (odds ratio = 4.03, 95% confidence interval = 2.17, 5.90), and the presence of side effects (odds ratio = 2.93, 95% confidence interval = 1.87, 3.98) were found to be determinants of Implanon discontinuation. Conclusion: According to this systematic review and meta-analysis, one-third of Ethiopian women discontinued Implanon before the recommended time (3 years). Program managers and service providers should consider using more evidence-based and participatory counseling approaches to enhance client satisfaction. Furthermore, family planning service delivery points should be equipped to manage and reassure women who are experiencing side effects.

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Section: Discussionmentioning

confidence: 99%

The prevalence of Implanon discontinuation and associated factors among Ethiopian women: A systematic review and meta-analysis

Habte¹,

Tamene²,

Woldeyohannes³

et al. 2022

Womens Health (Lond Engl)

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“…8 • Cases of pulmonary migration, infections, barium allergic reactions, and insertion-related neuropathies have been reported. 9 No effect has been observed on bone mineral density. 10,11…”

Section: Contextmentioning

confidence: 98%

Etonogestrel implant effectiveness

Dugré

Choksi²,

Kirkwood

2022

Can Fam Physician

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How does the etonogestrel implant (Nexplanon) compare with other long-acting reversible contraception? Bottom lineThe etonogestrel implant is effective, with 0 to 0.34 pregnancies per 100 women per year. In 1 RCT, the implant had a higher discontinuation rate (27% vs 20%), more amenorrhea (29% vs 9%), and lower patient satisfaction (66% vs 80%) compared with a low-dose levonorgestrel intrauterine device (IUD). EvidenceNo statistical analysis unless mentioned.

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“…Implant contraceptives can be a good option for patients with chronic diseases because, beyond their need for highly effective contraception, there are no clinically significant effects on lipid metabolism or liver function. According to the criteria of eligibility of contraception [ 4 , 5 ], their use is contraindicated in women with serious conditions such as severe cirrhosis and other benign and malignant liver tumors, thromboembolic or ischemic heart disease, suspicious vaginal bleeding, breast cancer, systemic lupus erythematosus and anti-phospholipid positivity, or hypersensitivity to any component of the method [ 6 ]. Other possible limitations are represented by social and psychiatric disorders, where the easy accessibility of the device becomes a negative feature.…”

Section: Introductionmentioning

confidence: 99%

Alternative Insertion Site of Nexplanon: Description of a Case Report and Systematic Review of the Literature

Stabile

Foti

Mordeglia

et al. 2022

JCM

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The etonogestrel (ENG) implant is among the most effective reversible contraceptives. It can be a good option for patients with different chronic diseases due to no clinically significant effects on lipid metabolism or liver function. Some limitations in the use of this type of device are represented by social and psychiatric disorders, where the easy accessibility of the device becomes a negative feature. In these patients several cases of self-removal or damage to the device have been reported. We report the successful insertion of the Nexplanon® device into the scapular region in a young woman with a chronic psychiatric disorder. To verify the presence in the literature of other possible implantation sites, we performed a systematic review of the literature on Pubmed, Google scholar and Scopus from 2000 to 2021 using different combinations of the following terms: (Nexplanon), (contraceptive implant), (insertion). Two manuscripts with three cases were detected. Nexplanon® was implanted in the upper back. In all cases, there were no complications during the insertions and the follow up demonstrated no side effects with contraceptive efficacy. Our report and review is a further confirmation that the scapular region can become a valid insertion site, maintaining good efficacy and safety of the subcutaneous device.

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Safety and Benefits of Contraceptives Implants: A Systematic Review

Cited by 36 publications

References 200 publications

The prevalence of Implanon discontinuation and associated factors among Ethiopian women: A systematic review and meta-analysis

The prevalence of Implanon discontinuation and associated factors among Ethiopian women: A systematic review and meta-analysis

Etonogestrel implant effectiveness

Alternative Insertion Site of Nexplanon: Description of a Case Report and Systematic Review of the Literature

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