Ectopic pregnancy with Implanon® as a method of contraception in a woman with a previous ectopic pregnancy – Case report

Olowu, O.; Karunaratne, Joanna; Odejinmi, Funlayo

doi:10.3109/13625187.2011.556278

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…The first case-report about ectopic pregnancy in reproductive-aged women users of Implanon was published in 2006 [55]; later, two other cases of ectopic pregnancy were described [56,57]. Implanon ectopic pregnancy could be due to the concomitant intake of drug-stimulating cytochrome P450, with a secondary increase in sex hormones' metabolism and reduction of their contraceptive action [55]; higher BMI values were suggested as a possible predisposing factor [57], but no definitive risk factors have been identified yet [56].…”

Section: Implanonmentioning

confidence: 99%

Safety and Benefits of Contraceptives Implants: A Systematic Review

et al. 2021

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Progestin-only contraceptive implants provide long-acting, highly effective reversible contraception. We searched the medical publications in PubMed, CENTRAL, and EMBASE for relevant articles on hormonal implants published in English between 1990 and 2021. Levonorgestrel (LNG) 6-capsule subdermal implants represented the first effective system approved for reversible contraception. The etonogestrel (ENG) single rod dispositive has been widely employed in clinical practice, since it is a highly effective and safe contraceptive method. Abnormal menstrual bleeding is a common ENG side effect, representing the main reason for its premature discontinuation. Emerging evidence demonstrated that it is possible to extend the use of the ENG implant beyond the three-year period for which it is approved. The ENG implant could be an effective and discrete alternative to the IUD in young girls, such as post-partum/post-abortion. Implants should be inserted by trained skilled clinicians who previously provide adequate counselling about their contraceptive effect, benefits, and any possible adverse events. More studies are needed to validate the extended use of the ENG implant for up to 5 years.

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Section: Implanonmentioning

confidence: 99%

Safety and Benefits of Contraceptives Implants: A Systematic Review

et al. 2021

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“…This may represent the fact that women who have already had one EP do not wish to expose themselves to anything else which may increase their risk of ectopic implantation (Bouyer et al 2003 ; Bouyer et al 2000 ; Mol et al 1995 ; Parashi et al 2014 ). Women who want to avoid a recurrent EP and need contraception sometimes opt for an implant but this also has its drawbacks as it has been shown that although the failure rate is extremely low the risk of EP is still present (Olowu et al 2011 ). The review by Rana et al showed that surgically managed EPs are decreasing and not the actual incidence of EP (Rana et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Recurrent ectopic pregnancy as a unique clinical sub group: a case control study

2016

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BackgroundWomen with recurrent ectopic pregnancy (EP) represent a unique cohort of patients in whom diagnostic expertise is paramount. We determined whether recurrent EP is associated with significant differences in patient demographics, clinical presentation, risk factors and surgical findings when compared with primary EP.MethodsA retrospective case–control study of all EPs diagnosed from 2003 to 2014, at Whipps Cross University Hospital, London.ResultsIn the above period 849 EPs were surgically managed (758 primary EPs and 91 recurrent EPs). Recurrent EPs were significantly older than primary EPs (32.2 ± 5.08 vs. 30.5 ± 5.83 years, p < 0.05). They presented at a significantly earlier gestation (5.99 ± 1.08 vs. 6.52 ± 1.81 weeks, p < 0.05) and with a significantly lower primary βHCG (3176 ± 7350 vs. 6243 ± 12,282, p < 0.05). Recurrent EPs were significantly more likely to have a positive history of tubal or pelvic surgery (61.5 % vs. 3.5 %, p < 0.05 and 53.8 vs. 14 %, p < 0.05). At surgery, primary EPs had a significantly greater volume of hemoperitoneum (592 ± 850 vs. 249 ± 391 ml, p < 0.05), whereas recurrent EPs were significantly more likely to have contralateral pathology (31.1 vs. 9.8 %, p < 0.05). Regression analysis showed that the parameters of age, gestational age at presentation, first βHCG level, positive history of previous tubal surgery and previous ectopic pregnancy differ in women at risk of a recurrent EP when compared to women not at risk of a recurrent ectopic (AUC, 0.844).ConclusionsWe conclude that recurrent EPs may represent a unique sub-group of patients with EP.

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“…Most of these pregnancies were conceived prior to the implant being inserted or becoming effective, or during concomitant use of enzyme-inducing drugs; in some cases, the implant had not in fact been successfully inserted 30–34. However a small number of cases of apparent true contraceptive failure have been documented 14,30,35–40…”

Section: How Effective Is the Etonogestrel Implant For Contraception?mentioning

confidence: 99%

“…A few individual cases of ectopic pregnancy during ENG-IMP use are reported in the literature 30–32,34,37,39,40,76. A review of clinical trials and marketing data for the ENG-IMP reported a rate of 0.2 ectopic pregnancies per 100 000 implants sold.…”

Section: Risk Of Adverse Health Events Associated With Use Of the mentioning

confidence: 99%

FSRH Guideline (February 2021) Progestogen-only Implant

2021

BMJ Sex Reprod Health

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Ectopic pregnancy with Implanon® as a method of contraception in a woman with a previous ectopic pregnancy – Case report

Cited by 6 publications

References 8 publications

Safety and Benefits of Contraceptives Implants: A Systematic Review

Safety and Benefits of Contraceptives Implants: A Systematic Review

Recurrent ectopic pregnancy as a unique clinical sub group: a case control study

FSRH Guideline (February 2021) Progestogen-only Implant

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