Evaluation of the Difficulty of Removing the Etonogestrel-Releasing Contraceptive Implant

• Grant number: 24/03733-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2024
• End date: June 30, 2025
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Cássia Raquel Teatin Juliato
• Grantee: Juliana de Toledo Piza Soares
• Host Institution: Centro de Atenção Integral à Saúde da Mulher (CAISM). Hospital da Mulher Professor Doutor José Aristodemo Pinotti. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Introduction: One of the barriers to the use of contraceptive implants worldwide is the difficulty and complications related to their removal. Objective: The objective of this study will be to evaluate the difficulties of removing the etonogestrel-releasing contraceptive implant in users of this method. Methods: A cross-sectional study with a convenience sample that will include all women who use the contraceptive implant and who attend the family planning outpatient clinic of CAISM/UNICAMP for removal. After signing the consent form, the participant will be asked about some sociodemographic and obstetric aspects, menstrual pattern, and reason for removal. Subsequently, the woman will undergo a physical examination of the implant insertion site, followed by an ultrasound examination with a portable POCUS device, which will determine the implant's location, depth, and presence of fibrosis. The implant will be removed, following the protocol of the service and the manufacturer. At the end, the woman will be asked about the occurrence of pain related to the procedure, and she should indicate the intensity of the pain on a visual analogue scale, from 0 to 10, where zero is the absence of pain, and 10 is the most intense pain possible. The doctor responsible for the procedure will be asked about the difficulty level. Statistical analysis: The data will be described with absolute and relative frequency for categorical variables and mean and standard deviation for numerical variables. The comparison between groups will be made using the Mann-Whitney test for numerical variables and the Chi-Square or Fisher's exact test for categorical variables. The significance level adopted will be 5%.