Use of modern contraceptive implants the: Lagos island maternity Hospital experience
Backround: Implants are an effective and reversible long term method of fertillty regulation, particularily advantageous to women who wish an extended period of contraception protection. The development of contraceptive implants was made possible by the discovery of silicone and its bio-compatibility in the human body. Silastic tubes with sealed ends and filled with steroids provided a sustained release of the steroids in vitro over months; these models were the precursors of today's contraceptive implants. This technology resulted in the development and patent of Norplant' and Norplant-2 by the Population Council. Over the years the popularity and use of Norplant has waned due to difficulties in insertion and removal. Lagos Island Maternity Hospital (LIM H) introduced Jadelle and Implanon- the newer forms of Implants in the year 2007 with the improvement made on these newer forms, we review the use of modern contraceptive Implant in LIMH.
Objectives: The objectives of this study are to demonstrate the socio-demographic and clinical variables influencing acceptors of modern contraceptive implants; to describe observed side effects associated with the use of contraceptive implants and to ascertain acceptance of contraceptive implants through determination of continuation rate.
Methodology: This involved a review of clients who were counseled and accepted subdermal contraceptive implants. The contraceptive implants were inserted by sub-dermal insertion of either Jadelle consisting of 2 rods. into the medial boarder of the upper arm or insertion of Implanon single rod in a similar anatomic location Data was extracted using an established family planning proforma. Data obtained included sociodemographic features, past obstetric/gynecological history of the respondents and side effects of the implants. Extraction of data was done over a period of one year.(July 31st 2011 to June 30th 2012)
Results: A total of 622 clients made use of various methods of contraception during the study period. The proportion of clients who made use of modern Implants is 11.41 % (n= 71). The average age of the respondents is 32years, with a range of 17.49years.The commonest side effect seen is amenorrhea, occurring in 12.7% of respondents (n = 9).lntermenstrual bleeding occurred in 4.2% of respondents (n =3). More of the respondents had insertion of Jadelle (69.0%: n= 49). The other respondents had insertion of Implanon (31%: n= 22). The proportion of clients who had no plan for further child bearing is 29.6% (n= 21). The majority of clients are desirous of further child bearing (70.4%: n=50).First time users constituted 52.1 % of clients (n= 37). Continuation rate was 90.1 % (0.9% discontinuation due to side effects). Some of the clients had used the cupper TIUD(19.7%: n= 14).
Conclusion: Contraceptive Implants have been shown by this study to be an acceptable form of contraception. Majority of the women maintained the use of the contraceptive implants, In women who experienced side effects, amenorrhea is the commonest side effect experienced. The relatively high continuation rate of these implants is a testament of its acceptability. Scaling up its uptake and availability will be useful in reducing the unmet needs for contraception.
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