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[Two patients with a non-palpable, subcutaneously implanted contraceptive].
M de Leeuw1, R J Oostenbroek, L Pijpers
1Afd. Chirurgie, Albert Schweitzer Ziekenhuis, Postbus 444, 3300 AK Dordrecht.
Nederlands Tijdschrift Voor Geneeskunde
|October 22, 2004
Summary
When a hormonal contraceptive implant is undetectable, check etonogestrel levels first. Imaging like ultrasound or MRI can then locate the implant if hormone levels confirm its presence, preventing unnecessary surgery.
Area of Science:
- Reproductive Medicine
- Medical Imaging
- Pharmacology
Background:
- Hormonal contraceptives, specifically subcutaneous implants releasing etonogestrel, are widely used for long-term birth control.
- Complications can arise if implants are not correctly placed or are difficult to locate for removal.
Observation:
- Two women presented with difficulties in locating their hormonal contraceptive implants after initial removal attempts by a general practitioner were unsuccessful.
- Standard diagnostic methods including physical examination, X-ray, echography, and MRI failed to detect the implants in both patients.
Findings:
- In one patient, a low etonogestrel level confirmed the absence of the contraceptive implant, suggesting it was never present or had been lost.
- The abstract highlights that if a subcutaneous contraceptive rod is not palpable, measuring the etonogestrel level is the crucial first step.
Implications:
- Incorrect subcutaneous contraceptive implantation can lead to challenges in localization and removal.
- Determining hormone levels should precede imaging and surgical exploration when an implant is not palpable.
- Proper implantation techniques are essential to prevent patient distress and complications associated with lost or undetectable contraceptives.