Abstract
Introduction The maternal mortality ratio (MMR) in Indonesia reaches 359 per 100,000 live births. The long-acting reversible contraceptive (LARC) method is an effective contraceptive choice for reducing MMR. The contraceptive implant is one of the LARCs that has low usage due to lack of education about the side effects. This study aims to compare the menstrual pattern and characteristics between one-rod and two-rod levonorgestrel implant users. Methods A prospective cohort study was performed in patients at Cipto Mangunkusumo Hospital (RSCM) from March 2016 to May 2018. Subject recruitment was done by consecutive sampling. This study was conducted from March 2016 until May 2019. Statistical analysis was performed on the data using the chi-square test to determine the relationship between menstrual pattern and characteristics, and the use of one-rod or two-rod levonorgestrel implants. Results A total of 140 subjects participated in the study, comprising 70 (50%) one-rod users and 70 (50%) two-rod users. In the first month, 32.9% one-rod users experienced amenorrhea, 22.9% experienced shortened menstrual period, 30% experienced normal menstrual period, and 14,2 % experienced lengthened menstrual period. In comparison, in the first month, 41.4% two-rod users experienced amenorrhea, 15.7% experienced shortened menstrual period, 32.9% experienced normal menstrual period, and 10% experienced lengthened menstrual period. There was no significant difference in menstrual patterns and characteristics between one-rod and two-rod levonorgestrel implant users. Conclusion There was no significant difference in menstrual patterns and characteristics between one-rod and two-rod levonorgestrel implant users. Implications. Menstrual patterns and characteristics from levonorgestrel implants user can help clinicians to reduce discontinuation rate from the acceptors. Further research should be conducted to know other side effects aside from menstrual bleeding patterns.
Highlights
Maternal death is a health problem experienced in both developing countries and developed countries
In 2015, the maternal mortality ratio (MMR) in developing countries was around 239 per 100,000 live births, while in long-acting reversible contraceptive (LARC) method is one of the contraceptive methods that are effective in reducing maternal death [1, 2]
We investigated whether there was a relationship between menstrual pattern characteristics in onerod and two-rod implants with body mass index and breastfeeding
Summary
Maternal death is a health problem experienced in both developing countries and developed countries. According to WHO (World Health Organization), maternal death is death that occurs during pregnancy and childbirth until 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes [1, 2]. In 2015, the MMR in developing countries was around 239 per 100,000 live births, while in long-acting reversible contraceptive (LARC) method is one of the contraceptive methods that are effective in reducing maternal death [1, 2]. Of all the LARCs, implants are the most effective contraception with a failure rate of less than 1% [5,6,7]. In terms of safety and usage, the implant is safe for women who are breastfeeding [11]
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