FSRH Progesterone -only Implant Flashcards
if a woman present for EC within the 4th year of use what would you suggest ?
Healthcare practitioners (HCPs) can advise individuals who present after unprotected
intercourse during the fourth year of use of an ENG-IMP that pregnancy risk is likely to
be very low and emergency contraception is unlikely to be required.
What do we need to tell people on enzyme inducers with an implant for contraception ?
contraceptive effectiveness of the ENG-IMP could be reduced during use of the enzyme-inducer and for 28 days after stopping the enzyme-inducer.
After taking UPA-EC how long should you wait before inserting an implant ?
5 days an then 7 days before it can relied on for contraception
Is contraceptive effectiveness of the implant affected by BMI ?
Current evidence would suggest it is not impacted by BMI
Is induction of bleeding required for people with PCOS and an Implant ?
No as long as the implant is within licensed duration of use.
What does the available evidence suggest about the association with current or recent use of hormonal (including progesterone only methods) contraception and breast cancer ?
small increase in breast cancer risk, but absolute risk removal very small
In what positions should an Implant ideally be placed ?
In line with manufacturer instructions, the point of insertion should be identified by measuring 8−10 cm proximally from the medial epicondyle along the sulcal line and then 3−5 cm posteriorly (over triceps), perpendicular to the sulcal line.
What does Nexplanon contain that makes its radio-opaque?
Barium sulphate
What is the primary contraceptive mechanism of action of the Nexplanon ?
Suppression of ovulation
secondarily, is also having effects on the endometrium and cervical mucus.
What is the produce license age of use for Nexplanon ?
18-40 years
In the fourth year of use of an implant to an LNG-IUS, what precautions need to be taken to exclude pregnancy ?
A pregnant test on day of fit that is negative and a repeat PT 21days after UPSI.
What concentration of etonogestrel is enough to suppress ovulation and how quickly are these reached ?
90pg/ml within a day of insertion
For which medical conditions is the implant UKMEC 4 ?
Current breast cancer
For which conditions in the implant a UKMEC 3 for continuation ?
History of stroke or ischaemic heart disease
Which conditions is the implant a UKMEC 3
unexplained vaginal bleeding at time of initiation, past breast cancer, decompensated liver disease, Hepatocellular adenoma or carcinoma
If 3 months of the COC is contraindicated for management of problematic bleeding with the implants than would would guidelines recommend second line ?
5 days of mefenamic acid 500mg TDS
Switching from implant to LNG IUS, implant is 3.5 years old, UPSI 3 days ago what do you do ?
If PT is negative on day, fit and PT 21days days post UPSI, condoms for 7 days
Switching from implant to non IUC hormonal, implant is 4.5 years old, UPSI 3 days ago what do you do ?
Consider EC, quick start none intrauterine contraception, PT 21 days after UPSI, condoms for as long as require before method active
Switching from implant to LNG IUS, implant is 4.5 years old, UPSI 3 days ago what do you do ?
Delay fit until pregnancy can be excluded with PT 21 days post UPSI, consider bridging
UPSI with implant in situ for 5 years, would like a copper coil ?
If all UPSI either ≥21 days ago or <5 days ago, insert immediately
If UPSI between 5 and 21 days ago, delay insertion until pregnancy excluded by negative PT 21 days after last UPSI
Consider oral EC
Consider bridging with CHC/POP/ ENG-IMP (or DMPA if other methods unsuitable or unacceptable)
Describe Jadelle and how long it is licensed for contraception
5 years, is a two rod LNG system
What is an adequate platelet count for implant procedure ?
platelet count over 50 x 10 to the power of 9
Describe Sino-implant and how long it is licensed for contraception
2 rod LNG-system, 4 years of use.
Describe Norplant and how long it is licensed for contraception
6 rod LNG system, 5 years
