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A Successful Removal of a Nonpalpable Etonogestrel Implant

Introduction: World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use guides the physician in recommending safe and effective contraception methods. In 2021, 61% out of 264 patients delivered in Sultan Ahmad Shah Medical Centre @IIUM (SASMEC@IIUM), chose etonogestrel impla...

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Main Authors: Abd Malik, Nur Rashidah, Hashim, Farih Najihah, Ismail, Hamizah
Format: Conference or Workshop Item
Language:English
Published: 2022
Subjects:
RG Gynecology and obstetrics
Online Access:http://irep.iium.edu.my/105163/12/105163_A%20Successful%20Removal%20of%20a%20Nonpalpable%20Etonogestrel%20Implant.pdf
http://irep.iium.edu.my/105163/
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spelling my.iium.irep.1051632023-07-03T09:39:34Z http://irep.iium.edu.my/105163/ A Successful Removal of a Nonpalpable Etonogestrel Implant Abd Malik, Nur Rashidah Hashim, Farih Najihah Ismail, Hamizah RG Gynecology and obstetrics Introduction: World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use guides the physician in recommending safe and effective contraception methods. In 2021, 61% out of 264 patients delivered in Sultan Ahmad Shah Medical Centre @IIUM (SASMEC@IIUM), chose etonogestrel implant for contraceptive method. Etonogestrel implant is a slow releasing progestin implant in a single, thin rod inserted sub dermally at the women’s inner side of the upper arm. It has low failure rate of 0.1% with quick return of fertility upon removal. Easy to insert yet some technical issues surrounding removal of impalpable implant after 3 years is an issue to consider. Case presentation: We presented a 23 years old, Para 1 who wished to remove the etonogestrel implant after 19 months. She complained of severe headache, amenorrhea and weight gain of 10kg. On assessment, the implant over her right arm was vaguely palpable, and removing it was clinically challenging. Ultrasound and X-ray of her right arm were performed to identify the location of the Implanon (etonogestrel implant). In contrast to usual method of stabilising the end of sub dermally palpable implant, in this case, approximation of the location of the implant was made based on measurement on the woman's X-ray of the upper arm. Pressure was applied on the estimated location pushing it towards initial incision made for removal of the implant. Discussion and conclusion: Despite subdermal insertion of implant, multiple factors can contribute to difficult removal. In this case report, it might be contributed by increase weight in the patient hence increase deposition of subcutaneous fat at insertion site or probable deeper insertion at initial setting. Hence, one physician needs to be well trained both in insertion and removal of Implanon. 2022-12-15 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/105163/12/105163_A%20Successful%20Removal%20of%20a%20Nonpalpable%20Etonogestrel%20Implant.pdf Abd Malik, Nur Rashidah and Hashim, Farih Najihah and Ismail, Hamizah (2022) A Successful Removal of a Nonpalpable Etonogestrel Implant. In: International Virtual Medical Research Symposium 2022, 15 December 2022, Kuantan, Malaysia. (Unpublished)
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic RG Gynecology and obstetrics
spellingShingle RG Gynecology and obstetrics
Abd Malik, Nur Rashidah
Hashim, Farih Najihah
Ismail, Hamizah
A Successful Removal of a Nonpalpable Etonogestrel Implant
description Introduction: World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use guides the physician in recommending safe and effective contraception methods. In 2021, 61% out of 264 patients delivered in Sultan Ahmad Shah Medical Centre @IIUM (SASMEC@IIUM), chose etonogestrel implant for contraceptive method. Etonogestrel implant is a slow releasing progestin implant in a single, thin rod inserted sub dermally at the women’s inner side of the upper arm. It has low failure rate of 0.1% with quick return of fertility upon removal. Easy to insert yet some technical issues surrounding removal of impalpable implant after 3 years is an issue to consider. Case presentation: We presented a 23 years old, Para 1 who wished to remove the etonogestrel implant after 19 months. She complained of severe headache, amenorrhea and weight gain of 10kg. On assessment, the implant over her right arm was vaguely palpable, and removing it was clinically challenging. Ultrasound and X-ray of her right arm were performed to identify the location of the Implanon (etonogestrel implant). In contrast to usual method of stabilising the end of sub dermally palpable implant, in this case, approximation of the location of the implant was made based on measurement on the woman's X-ray of the upper arm. Pressure was applied on the estimated location pushing it towards initial incision made for removal of the implant. Discussion and conclusion: Despite subdermal insertion of implant, multiple factors can contribute to difficult removal. In this case report, it might be contributed by increase weight in the patient hence increase deposition of subcutaneous fat at insertion site or probable deeper insertion at initial setting. Hence, one physician needs to be well trained both in insertion and removal of Implanon.
format Conference or Workshop Item
author Abd Malik, Nur Rashidah
Hashim, Farih Najihah
Ismail, Hamizah
author_facet Abd Malik, Nur Rashidah
Hashim, Farih Najihah
Ismail, Hamizah
author_sort Abd Malik, Nur Rashidah
title A Successful Removal of a Nonpalpable Etonogestrel Implant
title_short A Successful Removal of a Nonpalpable Etonogestrel Implant
title_full A Successful Removal of a Nonpalpable Etonogestrel Implant
title_fullStr A Successful Removal of a Nonpalpable Etonogestrel Implant
title_full_unstemmed A Successful Removal of a Nonpalpable Etonogestrel Implant
title_sort successful removal of a nonpalpable etonogestrel implant
publishDate 2022
url http://irep.iium.edu.my/105163/12/105163_A%20Successful%20Removal%20of%20a%20Nonpalpable%20Etonogestrel%20Implant.pdf
http://irep.iium.edu.my/105163/
_version_ 1770550866258952192
score 13.211869

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