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Ectopic pregnancy with etonogestrel implant
Marta Luísa Rodrigues1, Rute Branco2, Elsa Landim2
1Woman's Department, Obstetrics and Gynaecology, Hospital Professor Doutor Fernando Fonseca EPE, Amadora, Lisboa, Portugal martaluisa89@gmail.com.
BMJ Case Reports
|November 17, 2021
Summary
Etonogestrel implants are highly effective contraceptives. However, a rare case of ectopic pregnancy occurred despite a properly functioning implant within normal concentration limits.
Area of Science:
- Reproductive Health
- Contraception
- Obstetrics & Gynecology
Background:
- The etonogestrel implant is a progestin-only subdermal contraceptive rod.
- It is recognized as one of the most effective reversible methods of contraception.
- Typical and perfect use failure rates are very low.
Observation:
- A case study of a woman utilizing an etonogestrel implant for contraception is presented.
- The implant had been in place for 15 months.
- The patient experienced an ectopic pregnancy.
Findings:
- Despite the presence of the etonogestrel implant, an ectopic pregnancy was diagnosed.
- Serum concentrations of etonogestrel were measured and found to be within the expected therapeutic range.
- This suggests that contraceptive failure, while rare, can still occur.
Implications:
- This case highlights the rare possibility of contraceptive failure with etonogestrel implants.
- It underscores the importance of considering ectopic pregnancy in women with implants presenting with relevant symptoms.
- Further research into mechanisms of contraceptive failure, even with adequate drug levels, may be warranted.
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