In Practice

Migration of etonogestrel contraceptive implants: Implications for difficult removals services need in southern Africa

G A Petro, T Spence, J-P du Plessis, A M Gertz, C Morroni

Abstract


The first difficult contraceptive implant removals clinic in sub-Saharan Africa was started 2 years ago at New Somerset Hospital in Cape Town, South Africa, and has seen two cases of implant migration. We report these cases here. The first was a case of fascial migration and the second one of migration via the cephalic vein, both to a site just anterior to the glenohumeral joint. Both implants were removed without complications. Even with correct insertion technique, migrations can occur. Healthcare providers need to know how to manage difficult removals, and how to access and refer to difficult removals services when necessary. These services must therefore be available in all settings where implants are offered, to ensure access to rights-based family planning services for all women in southern Africa.


Authors' affiliations

G A Petro, Department of Obstetrics and Gynaecology, New Somerset Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

T Spence, Department of Obstetrics and Gynaecology, New Somerset Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

J-P du Plessis, Department of Orthopaedic Surgery, New Somerset Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

A M Gertz, Botswana Harvard Partnership, Gaborone, Botswana; Botswana UPenn Partnership, Gaborone, Botswana

C Morroni, Botswana UPenn Partnership, Gaborone, Botswana; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK; Women’s Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

Contraceptive implant; Difficult removal; Migration; South Africa

Cite this article

South African Medical Journal 2019;109(8):559-561. DOI:10.7196/SAMJ.2019.v109i8.14061

Article History

Date submitted: 2019-07-26
Date published: 2019-07-26

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