Contraceptive Implant Concern
The MHRA recently reported contraceptive implant concern following reports of Nexplanon implants having reached caused injury to women who have used the contraceptive. The injury was caused by the implant migrating to the lung via the pulmonary artery giving rise to the MHRA issuing contraceptive implant concern.
Nexplanon is a small, soft, and flexible birth control implant which is 4 centimeters in length.
Your GP will place it under the skin on the inside of your upper arm. It is then said to provide up to 3 years of continuous pregnancy prevention by preventing ovulation. However, the implant should only be inserted subdermally and by a healthcare professional who has been appropriately trained and accredited.
Nexplanon has been recommended fro 18-40 year olds. After 40 years old your GP speak to your GP about alternative contraceptive options. Speak to your GP if you have contraceptive implant concern.
Doctors are advised not to insert the implant over the sulcus (groove) between the biceps and triceps and to take care to avoid insertion close to any blood vessels or nerve bundles eg the ulnar nerve. The doctor should be able to feel the implant on palpation and should teach you how to locate it too.
The MHRA advice is that if you are unable to locate the implant use specialist imaging and if that fails to locate it then have it removed at the earliest opportunity.
If the implant cannot be located in the arm then chest imaging is recommended. If it is located in the chest, it is likely that it will require surgical removal.
Reports and potential risk factors
The number of reports of Nexplanon implants in the vasculature received by the licence-holder is estimated to be approximately 1.3 per million implants sold worldwide. This has prompted the contraceptive implant concern.
Whilst no definitive set of adverse reactions have been ascertained the following have been reported:
- dyspnoea – shortness of breath or breathlessness
- haematoma at the insertion site
- excessive bruising at the insertion site
- deep insertion
- insertion in an inappropriate site
- insertion in thin arms
- endothelised into the pulmonary artery.
- Pregnancy – Nearly 600 women have become pregnant despite using an implant.
There have also been more than 1,600 reports of adverse reactions to the Implanon device, which is designed to prevent pregnancy for three years. The NHS has been forced to pay compensation to several women because of the failures, Channel 4 News reported.
The implant maker, MSD, said no contraceptive was 100% effective.
An implant that cannot be palpated at its insertion site in the arm should be located as soon as possible and removed at the earliest opportunity. If an implant cannot be located within the arm, perform chest imaging. Correct subdermal insertion reduces the risk of these events.
Reporting of suspected adverse reactions
If you have Contraceptive Implant Concern then please do report any suspected side effects to the MHRA on their Yellow Card scheme including difficulties with insertion or removal of Nexplanon or Implanton.
If you have suffered an injury or an adverse effect of a concracpetive implant contact us today on 0800 470 2009 or email Dr Victoria Handley with your Contraceptive Implant Concerns at vhandley@handleylaw.co.uk