Gregory Petro1, Trevi Spence2, Malika Patel3, Alida M Gertz4, Chelsea Morroni5. 1. Department of Obstetrics and Gynaecology: New Somerset Hospital and University of Cape Town, Cape Town, South Africa. Electronic address: Gregory.Petro@westerncape.gov.za. 2. Department of Obstetrics and Gynaecology: New Somerset Hospital and University of Cape Town, Cape Town, South Africa. 3. Department of Obstetrics and Gynaecology: Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. 4. Botswana Harvard HIV/AIDS Institute Partnership, Gaborone, Botswana. 5. Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK; Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa; Botswana UPenn Partnership, Gaborone, Botswana.
Abstract
OBJECTIVES: To assess etonogestrel contraceptive implant location and outcomes among women referred for "difficult" removal to a specialist clinic in South Africa. STUDY DESIGN: We performed a retrospective review of cases referred to our clinic for removal of nonpalpable, deep, migrated, or damaged implants, or failed removals from March to August 2017. RESULTS: Most (n = 68, 92%) of the 74 referrals were nonpalpable in our clinic. We used ultrasound for localization and successfully removed 72 implants (97%) in the outpatient clinic. CONCLUSION: With proper protocols and equipment, localization and removal of nonpalpable implants can be safely and effectively achieved in an outpatient African setting. IMPLICATIONS: Access to providers specially trained in ultrasound localization should be available in all settings where implants are offered. Providing timely access to safe and effective implant removals in routine and difficult cases is essential to ensuring that implant programs are in alignment with rights-based, client-centered family planning principles.
OBJECTIVES: To assess etonogestrel contraceptive implant location and outcomes among women referred for "difficult" removal to a specialist clinic in South Africa. STUDY DESIGN: We performed a retrospective review of cases referred to our clinic for removal of nonpalpable, deep, migrated, or damaged implants, or failed removals from March to August 2017. RESULTS: Most (n = 68, 92%) of the 74 referrals were nonpalpable in our clinic. We used ultrasound for localization and successfully removed 72 implants (97%) in the outpatient clinic. CONCLUSION: With proper protocols and equipment, localization and removal of nonpalpable implants can be safely and effectively achieved in an outpatient African setting. IMPLICATIONS: Access to providers specially trained in ultrasound localization should be available in all settings where implants are offered. Providing timely access to safe and effective implant removals in routine and difficult cases is essential to ensuring that implant programs are in alignment with rights-based, client-centered family planning principles.
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