Abstract
A total of 324 women aged 18-35 began use of NORPLANT subdermal implants in Finland Chile and the Dominican Republic in 1978-79. Through 4 years of 1st segment use the average annual continuation rate was 84/100 women and the 4 year cumulative rate was 49/100. There were no pregnancies in the 1st 2.5 years of use and a total of 2 by the end of 4 years. Single decrement (gross) pregnancy rate cumulated to 1.2/100 users at the end of month 48 and the Pearl index through 4 years was .2/100 woman years. Placement and removal of implants subject women to the risk of infection at the implant site. The use of implants as a practical method of family planning rests in part on the question of whether these relatively simple clinical procedures can be performed with a low infection rate under field conditions. Marked bleeding patterns were a concern. Some women experienced very long bleeding runs. With adequate training and supervision delivery and removal of implants can be done quickly and safely as indicated by the low infection rates (0.3/100 women). The training of personnel in the required skills is apparently no more difficult than was the training for the IUD 2 decades ago. Infection should it occur would tend to have less serious consequences for the woman than does pelvic infection. Perforation of the uterus in delivery of a copper IUD requires abdominal surgery to remove the device. No equally serious sequelae have been associated with improper placement or removal of implants.
Published Version
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