IMPLANON FAILURE LEADING TO THE RUPTURED ECTOPIC PREGNANCY: AN UNUSUAL OCCURANCE
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Keywords
Ectopic, implanon, pregnancy, bhcg, Failure, etonogestrel
Abstract
Implanon is a contraceptive implant pre-loaded in a disposable applicator for the women of reproductive age. It is a single small soft, flexible plastic rod of 4.0 cm length and 2.0mm in diameter, which is placed subcutaneously under the skin of the non-dominant arm 3-4 cm below the vascular groove between the biceps and the triceps muscles and 8-10 cm above the medial epicondyle of the humerus bone. It is effective for 3.0 years and has etonogestrel 68 mg, out of which a small amount of the etonogestrel in continuously released in the blood stream. It is made up of ethylene vinyl acetate copolymer, a plastic that will not dissolve in the body. It also contains a small amount of barium sulfate which renders it visible under X-Ray. We do not have many studies available about the pregnancy with the Implanon. How ever the failure rate of the implanon was claimed as 1 in 1000 insertions. We report a case where the implanon was inserted for 17 months and the patient presented with the continuous bleeding and the abdominal pain, and the pregnancy was diagnosed by doing the serial BHCG levels and was found to be ectopic. She was admitted for the medical management, however, during admission, it was ruptured which was diagnosed and immediately shifted for the laparotomy. Her left salpingectomy was done, and the patient remained stable thereafter.
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Dr. Saima Najam
Ex-Assistant Professor, The Obgyn Department at CMH Lahore, Pakistan, FCPS, PG Certification in Medical Education, (Dundee), Head of the Obgyn Department Dr. Sulaiman Al Habib Hospital, Sweidi, Riyadh, Saudi Arabia
Dr. Azza Algharbawy
Consultant, Obgyn Department, Dr. Sulaiman Al Habib Hospital, Sweidi, Riyadh, Saudi Arabia
Dr. Nida Rizwan Haider
Medical Officer, Jshq, Mrc, Rawalpindi, Pakistan
Syeda Ifra Hassan
Student Of MBBS, At Almaarefa College Of Science and Technology Riyadh