Subcutaneous etonogestrel implant - continuation rate in standard indication and after induced abortion: a 3-year evaluation.
ESC Congress Library. Vaz de Macedo C. May 28, 2014; 50594; A-179 Disclosure(s): None to disclose.
Dr. Carolina Vaz de Macedo
Dr. Carolina Vaz de Macedo
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1. Objectives
Etonogestrel subcutaneous implant (ETN SCI) is claimed as a long acting contraceptive method (LARC). Even though its contraception efficacy is very high, a possible disruption of the bleeding patterns can produce early discontinuation, particularly during the first year. In our previous data on ETN SCI for regular contraception, a low continuation rate was evident; 256 out of 504 women abandoned follow-up, with only 99 (39,9%) opting for renewal. The main purpose of this study was the evaluation of ETN SCI continuation rate in women from our Family Planning Unit with regular use for contraception and contraception after induce abortion.

2. Method
Women who chose implant for regular contraception and women with a recent history of induced abortion were included. Clinical files were evaluated from 2008 to 2010 (December), with analysis of at least 3 years. We included 166 cases, 88 regarding regular contraception (WRC) and 78 from women after induced abortion (WAIA). Data collection included: age, bleeding patterns, continuation rate and reasons for discontinuation. Descriptive statistics were conducted and data are presented as absolute values, percentages, mean and standard deviation (SD).

3. Results
The mean age (±SD) was 29.7±9.16 years (range 13-52) for the WRC group and 27.8±6.47 years (range 15-48) for the WAIA group. The renewal rate after 3 years was 17/88 in the WRC group and 10/78 in the WAIA group. In both groups, 26 women changed to a different contraceptive method or suspended contraception due to pregnancy desire. Losses to follow-up were 45/88 in the WRC group and 42/78 in the WAIA group. Among women who pursued their attendance at the Unit, the mean duration of use (±SD) was 33.5±11.47 months (range 12-72) for the WRC group and 27.5±10.92 months (range 12-48) for the WAIA group.

4. Discussion
Long acting reversible contraception is strongly recommended in women after induced abortion supposing that contraception methods with long duration will reinforce efficacy on contraception and therefore minimize repeated abortion. The results in this sample of women with regular indication for contraception and after induced abortion in a long term analysis, show low continuation rates (17/88 WRC, mean of duration 33.5 months, 10/78 WAIA and mean value of duration 27.5 months) of ETN SCI with an alarming rate of losses to follow-up. These rates must be borne in mind when considering ETN SCI as a long acting reversible contraception, particularly after induced abortion.

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