Unintended pregnancy and the role of long-acting reversible contraception

Modi, Monica N.; Heitmann, Ryan J.; Armstrong, Alicia

doi:10.1586/17474108.2013.848596

Cited by 9 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estrogen and progesterone are metabolized by the hepatic enzyme CYP450 3A4 (CYP) system [10,11]. CYP450 3A4 inducers have shown to decrease the efficacy of implanted LARCs, particularly, the use of antiepileptic medication (AED) [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…The implant manufacturer, Merck Sharp & Dohme (MSD) stated that Implanon had shown to be more than 99% effective in clinical trials, and asserted that there is no contraceptive that is 100% effective [9]. The mechanism of action of Implanon relies on the suppression of ovulation through hypothalamic pituitary ovarian (HPO) axis dysregulation and promotes thickening of the cervical mucus preventing fertilization [10]. Between 1999 and 2011, over 1.4 million women used Implanon [1,2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unintended Pregnancy with Implantable Subdermal Contraceptive Device (Nexplanon): A Case Report

Rezai¹,

Patel²,

Hughes³

et al. 2018

OGIJ

View full text Add to dashboard Cite

Background: In 2006, Implanon (68 mg), a synthetic subcutaneous progestin etonogestrel eluting capsule, was approved for use in the U.S. to provide longacting reversible contraception (LARC). The next generation LARC, Nexplanon (68 mg), a progestin-only etonogestrel subdermal implant, was available in 2001. Currently, Nexplanon is advertised to provide 99% effective contraception, up to 4 years. Removal of the capsule will revert back to normal menstruation and fertility. Unlike Implanon, cases of unintended uterine pregnancy with proper and successful insertion have not been reported using Nexplanon. Case:A 24-year-old female, G2P1001, with obstetrical history of one spontaneous vaginal delivery (2015), and gynecological history of low grade squamous intraepithelial lesion (LSIL) on Pap smear (2014), was found to have an intrauterine pregnancy while using Nexplanon. Initially, urine pregnancy testing assured that she was not pregnant before placement of the Nexplanon. Nexplanon was inserted ~2 months post-partum after the birth of her first child.17 months post-Nexplanon insertion, patient experienced irregular spotting, cramping, and reported positive home pregnancy test. Transvaginal ultrasound confirmed an intrauterine pregnancy at 9 weeks and 3 days. The Nexplanon implant was removed intact. Routine prenatal care was initiated and no issues were identified. Conclusion:Newer LARCs provide an alternative to lifestyle adaptive contraception, with ease of use and compliance. Although LARCs prove to be more effective, known factors linked to human error during placement, cytochrome P450 induction, and BMI, have shown to decrease their efficacy, leading to failed contraception. be associated with an unintended uterine pregnancy with proper and successful insertion. Keywords:Contraindications for the implant include; known or suspected pregnancy, current or past history of thrombosis or thromboembolic disorders, liver tumors (benign or malignant), active liver disease, undiagnosed abnormal genital bleeding, known or suspected breast cancer, personal history of breast cancer, other progestin-sensitive cancer and allergies to the components of Nexplanon [12,13]. Side effects of Nexplanon include; irregular menses, headache, vaginitis, breast pain, weight gain, acne, abdominal pain, and pharyngitis [12,13]. Although Nexplanon is used to prevent pregnancy, if the implant fails, there is an increased risk for ectopic pregnancy [12]. We present the first case of intrauterine pregnancy while using Nexplanon [14]. Case ReportThis patient is a 24-year-old female, G2P1001, with past medical history of asthma controlled with albuterol, asthmatic bronchitis treated with amoxicillin, and iron deficiency anemia was found to have an intrauterine pregnancy while using Nexplanon. Obstetrical history is significant for one spontaneous vaginal delivery in 2015, and gynecological history includes low grade squamous intraepithelial lesion (LSIL) on pap smear in 2014, with no further abnormal pap smears. She had used Nexplanon ...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Unintended Pregnancy with Implantable Subdermal Contraceptive Device (Nexplanon): A Case Report

Rezai¹,

Patel²,

Hughes³

et al. 2018

OGIJ

View full text Add to dashboard Cite

show abstract

“…De modo geral, esses casos ocorrem em todos os estratos socioeconômicos da população, além de ser um problema mundial que impacta especialmente países em desenvolvimento (Modi et al, 2013). De acordo com dados da literatura, no ano de 2008, foi estimado que 41% das 208 milhões de gestações que ocorreram ao redor do mundo não eram planejadas (Modi et al, 2013).…”

Section: Introductionunclassified

“…De acordo com dados da literatura, no ano de 2008, foi estimado que 41% das 208 milhões de gestações que ocorreram ao redor do mundo não eram planejadas (Modi et al, 2013).…”

Section: Introductionunclassified

See 1 more Smart Citation

Custo-efetividade do uso do sistema intrauterino liberador de 52 mg de levonorgestrel (SIU-LNG) versus contraceptivos hormonais de curta duração na prevenção de gravidez não desejada em adolescentes entre 15 e 19 anos sob a perspectiva do SUS

Pepe¹,

Sakagute²,

Ramos³

et al. 2017

JBES

View full text Add to dashboard Cite

Objetivo: O objetivo deste trabalho foi avaliar se o uso do sistema liberador de levonorgestrel (SIU- -LNG) Mirena® é custo-efetivo na prevenção de gravidez não planejada em adolescentes, entre 15 e 19 anos, quando comparado aos contraceptivos hormonais de curta duração sob a perspectiva do Sistema Único de Saúde (SUS). Métodos: Para avaliação econômica, foi elaborado um modelo de Markov, com ciclos de um ano, que acompanhou as adolescentes ao longo do curso natural do uso do método contraceptivo por um horizonte de tempo de cinco anos. Dados clínicos foram obtidos de revisão da literatura. Custos unitários foram extraídos de bases de dados oficiais. Apenas custos médicos diretos foram contemplados. Custos e benefícios foram descontados a uma taxa de 5% ao ano. Desfechos foram expressos como gravidez não planejada evitada. Resultados: Os resultados da análise de custo-efetividade mostraram que SIU-LNG é capaz de gerar economia de recursos com ganho em efetividade quando comparado com os métodos de maior prevalência de uso na adolescência (ACO e ACI). Análises de sensibilidade foram realizadas comprovando os resultados encontrados no caso-base. Conclusão: Levando-se em conta os resultados satisfatórios clínicos e econômicos, SIU-LNG deve ser considerado uma importante opção para evitar a gravidez não planejada na adolescência e todas as suas consequências.

show abstract

Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil

Moreira

Ewerling

Santos

et al. 2020

Int J Public Health

View full text Add to dashboard Cite

Objectives To assess time trends in unplanned pregnancy, stratified by sociodemographic status, reproductive history, and inequalities in family income and women's skin color, in Pelotas, Brazil. Methods Data from mothers of participants of the 1993 (N = 5264), 2004 (N = 4243), and 2015 (N = 4268) Pelotas birth cohorts were analyzed. Unplanned pregnancy was investigated in the perinatal period, with tests to assess changes over time among different sociodemographic and reproductive history subgroups and inequalities as a function of family income and skin color. Results The prevalence of unplanned pregnancy was 62.7% (3299/ 5264), 65.9% (2794/ 4243), and 52.2% (2226/ 4268) in the 1993, 2004, and 2015 cohorts, respectively. Black or brown women and women of lower socioeconomic status had a higher prevalence of unplanned pregnancy in all cohorts. The overall rate of unplanned pregnancy decreased over time in most subgroups. Inequality as a function of family income and skin color increased during the time frame of assessment. Conclusions The prevalence of unplanned pregnancies decreased in the period analyzed, but it is still unjustifiably high. Efforts aimed at reducing unplanned pregnancy are vital and will require special attention to the most vulnerable groups.

show abstract

Unintended pregnancy and the role of long-acting reversible contraception

Cited by 9 publications

References 34 publications

Unintended Pregnancy with Implantable Subdermal Contraceptive Device (Nexplanon): A Case Report

Unintended Pregnancy with Implantable Subdermal Contraceptive Device (Nexplanon): A Case Report

Custo-efetividade do uso do sistema intrauterino liberador de 52 mg de levonorgestrel (SIU-LNG) versus contraceptivos hormonais de curta duração na prevenção de gravidez não desejada em adolescentes entre 15 e 19 anos sob a perspectiva do SUS

Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil

Contact Info

Product

Resources

About