Najma Javed, Taqdees Mehmood, Humaira Almas.
Experiences of women and assessment of efficacy and side effects of sub-dermal implants in rural Islamabad.
Pak J Med Res Jan ;55(4):99-102.

Background: One of the millennium development goals is to improve the quality of women’s health through choice, accessibility and gender equality. Contraception plays an important role to reduce maternal and child mortality by avoiding unwanted pregnancies. Objectives: To study the acceptability, success rate and short term side effects of sub-dermal contraceptive implants (SCI) available as SINO Implant (II) and to determine the reasons for its discontinuation. Study design, settings and duration Descriptive prospective study conducted at a Private Medical Centre, Trameri, Islamabad from February 2015– February 2016. Subjects and Methods: All women aged between 25-45 years wishing to use sub-dermal contraceptive implants were included in the study. Women with bleeding disorders and those weighing > 80kg were excluded. All women were explained about the study and written informed consent was taken. The contraceptive implants SINO (II) containing Levonorgestrel were placed under local anesthesia. A questionnaire was used to collect information on demography and study specific variables e.g. side effects, implant acceptability, satisfaction and reasons for discontinuation. Women were followed at the clinic and also telephonically at interval of one and six month post insertion. Results: Out of 105 women, 08 did not meet the criteria for insertion and were excluded, while 97 women were enrolled for the study. Their mean age was 31 years (SD ± 5.34). Minimum parity was 01 and maximum 07. Mean period of last child birth (LCB) before implant insertion was 25.35 months (SD ± 32.86, range 1-156 months). Out of 97 women, 51 (53.4%) were using some kind of contraception prior to the placement of implant. Most common side effect of implant were spotting 17 (18%) followed by irregular vaginal bleeding and weight gain in 11 (12.2%) each. At 6 months, rate of continuation of implant was 82.7% with 62 (64%) women having no complaints at all while 35 (36%) experienced some. After 6 months, 77 women (79%) continued to use the implant, while 12 discontinued it (5 had removed in first 3 months, 7 between 3 and 6 month after insertion). Conclusion: Sub-dermal contraceptive implants were safe and convenient to use with high acceptability. They can be used as the method of choice for long term reversible contraception. Key words: Sub-dermal contraceptive implant, reversible contraception, levonorgestrel.

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