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The Etonogestrel Implant in Adolescents: Factors Associated With Removal for Bothersome Bleeding in the First Year After Insertion
Journal of Pediatric and Adolescent Gynecology ( IF 1.8 ) Pub Date : 2021-06-02 , DOI: 10.1016/j.jpag.2021.05.011
Sarah Green 1 , Jeanelle Sheeder 2 , Molly Richards 1
Affiliation  

Study Objective

Temporizing measures such as hormonal pills can temporarily improve the side effect of breakthrough bleeding in individuals using the etonogestrel implant. The aims of this study were to determine demographic factors that are associated with bothersome bleeding and to evaluate the impact of prescribing temporizing measures on implant continuation.

Design

Retrospective chart review.

Setting

The research was conducted in an adolescent medicine primary and specialty care clinic, an adolescent family planning clinic, and a clinic that cares for parenting adolescents.

Participants

A chart review was conducted on 1200 patients aged 12-24 years who received the implant in 2016.

Interventions and Main Outcome Measures

The primary outcome measure was removal of the implant within the first year of use. We followed each patient for 1 year to determine rates of removal, reasons for removal, and temporizing measures prescribed for bleeding.

Results

Younger age and lower body mass index were associated with reporting bothersome vaginal bleeding. Patients who were nulliparous or had bothersome bleeding were more likely to have the implant removed in the first year. Patients who received a temporizing measure for bleeding were more likely to retain the implant for 1 year than were those who did not receive one (67.1% vs 40%, P < .001).

Conclusions

Some patients are more likely to report concerns with bleeding or to have the implant removed in the first year after insertion. Prescribing temporizing measures to control bothersome vaginal bleeding may decrease rates of removal in the first year.



中文翻译:

青少年的依托孕烯植入物:植入后第一年因令人烦恼的出血而移除的相关因素

学习目标

激素丸等临时措施可以暂时改善使用依托孕烯植入物的个体突破性出血的副作用。本研究的目的是确定与麻烦的出血相关的人口统计学因素,并评估开具临时措施对种植体延续性的影响。

设计

回顾性图表审查。

环境

该研究是在青少年医学初级和专科诊所、青少年计划生育诊所和照顾青少年的诊所进行的。

参与者

对 2016 年接受植入物的 1200 名 12-24 岁患者进行了图表审查。

干预措施和主要结果措施

主要结果测量是在使用的第一年内移除植入物。我们对每位患者进行了为期 1 年的随访,以确定移除率、移除原因以及针对出血规定的临时措施。

结果

较年轻的年龄和较低的体重指数与报告令人烦恼的阴道出血有关。未生育或有严重出血的患者更有可能在第一年移除植入物。接受临时出血措施的患者比未接受临时措施的患者更有可能保留植入物 1 年(67.1% 对 40%,P < .001)。

结论

一些患者更有可能报告对出血的担忧或在植入后的第一年移除植入物。开出临时措施来控制麻烦的阴道出血可能会降低第一年的去除率。

更新日期:2021-06-02
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