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A.

Definition Implant
Contraception threaded under the skin of the upper arm side in the form of capsules silastik (flexible)
length is slightly shorter than the matchstick and in each bar contains the hormone levonorgestrel that can
prevent pregnancy (BKKBN, 2006).
Contraceptive implants are shaped rod containing progestin. After the midwife numbing the skin by using
an anesthetic, then a tool such as a needle (trocar) used to place the implant under the skin on the upper
arm. Implant does not require sutures on the skin. Slowly, the implant releases progestin into the
bloodstream. The implant is effective for 3 years.
B. Implant type
The types of implants according to Saifuddin (2006) is as follows:
a. Norplant consists of six rods silastik soft hollow with 3.4 cm long with a diameter of 2.4 mm, which is
filled with 36 mg of levonorgestrel and his 5-year old.
b. Implanon consists of one white flexible rod with a length of approximately 40 mm, and a diameter of 2
mm, which is filled with 68 mg ketodesogestrel and his 3 year old.
c. Jadena and Indoplant consists of two rods containing 75 mg of levonorgestrel at work 3 years old.
C. Working Mechanism
How it works implants every implant capsule containing 36 mg of levonorgestrel released every day as
much as 80 mg. The concept is its mechanism of action according Manuaba
1) Can blocking LH spending so that ovulation does not occur.
2) thicken cervical mucus and hinder the migration of spermatozoa.
3) Diluting the endometrium so not ready to be a nidasi.
D. Effectiveness Implant
According Hartanto, (2002) the effectiveness of the implant are:
a. Norplant a failure rate of approximately 1 per 100 women per year in the first five years. This is lower
than oral contraceptives, IUDs and barrier methods.
b. Effectiveness Norplant is reduced slightly after 5 years and in the year to 6 approximately 2.5-3%
acceptors become pregnant.
c. -2 Norplant as effective as Norplant also be effective for five years, but it turns out after 3 years use
pregnancy occurs in a large number of unforeseen, ie 5-6%. The cause is unclear, unexpected decline in
the release of hormones.
E. Indications

Postpartum women. Women with breast cancer and uterine myoma. Women with bleeding pervaginaan penyababnya unclear. b. Women of reproductive age (20-30 years). F. F. G. Women who can not accept change in menstrual patterns that occur. Nursing women and in need of contraception. Women who do not want more children. Women who want contraception that have a high effectiveness and require long-term pregnancy prevention.Implant according to Saifuddin (2006) can be done at: a. b. d. Women with lumps / breast cancer or a history of breast cancer. h. Women who often forget pills. Women who should not use hormonal contraceptives containing estrogen. e. Advantages Advantages of the implant according to Saifuddin (2006) are: . Women with lumps / breast cancer or a history of breast cancer. g. Women after a miscarriage. refuse sterilization. i. d. Women who are pregnant or suspected pregnancy. Women who are pregnant or suspected pregnancy. b. f. Women with breast cancer and uterine myoma. d. Women with bleeding pervaginaan penyababnya unclear. c. Contraindications According to Saifuddin (2006) explains that the implant is contraindicated as follows: a. Women who have had children or who have not. c. e. e. Women who can not accept change in menstrual patterns that occur. Contraindications According to Saifuddin (2006) explains that the implant is contraindicated as follows: a. c.

f. Losses implant Hartanto. g) Do not interfere with breastfeeding. f) Do not interfere with intercourse activities. (2002) suggested that the loss of implants are: a. g) Reduce the incidence of endometriosis. d) Does not require examination. d) Protect the occurrence of endometrial cancer. More expensive costs. e) Reduce the incidence of breast abnormalities child. Advantages of contraception. Insertion and expenditure must be carried out by trained personnel. f) Protect yourself from some of the causes of inflammatory diseases pangul. e. b. d. c. . b) Long-term protection (up to 5 years). namely: a) The performance high. b. namely: a) Reduce menstrual pain. Medical officers require training and practice for the insertion and removal of the implant.a. Acceptor can not stop at will implant itself. h) The client only needs to go back to the clinic if there are complaints. i) It can be revoked at any time according to need. b) Reduce the amount of menstrual blood c) Reduce / improve anemia. H. c) Return of fertility levels quickly after revocation. e) Free from the influence of estrogen. Non-contraceptive advantages. Some women may be reluctant to use it because it is less known him. Often resulting changes in menstrual patterns.

c. especially in the first year. spotting (spotting) light i. When suspected ectopic pregnancy. iii. After 6 capsules fitted. i. Trocar is inserted subcutaneously to the limit. g. lift the implant and angjurkan using other contraceptives. The installation site on the upper left arm. special counseling alone. There is no point giving hormone drugs to provoke the onset of bleeding. f. Explain to the client that will be bleeding after the combination pill exhausted. d. and is driven by a driving tool until there is any resistance. If the client still does not accept. ii. b. Explain that light bleeding is common. referred clients. To put the capsule. Engineering installation place with proper (if composed of 6 capsules of fruit like an open fan). Side effects / complications and how Abatement Saifuddin J. trocar is pulled out. ii. A small incision is made. How to install According Manuaba implant placement technique is as follows: a. Amenorrhoea i. If the client still complain of bleeding problems and want to continue the use of implants can be given the combination pill cycle. b. This technique applies to all types of implant. The capsule is inserted into the trocar. To ensure that the capsule had been in place. the driving tool is inserted until it feels no prisoners. Make sure pregnant or not pregnant. h. . that the progestin is not harmful to the fetus. In the event of pregnancy and the client wants to continue her pregnancy. Implant can sometimes be visible to others. (2006) explains that the side effects / complications and ways to overcome them are as follows: a. so that the trocar can enter. if not pregnant do not require special handling. or ibuprofen 3 x 800 mg for 5 days. e. remove the implant and explain.g. no action was necessary. Bleeding. If there is no problem and the client is not pregnant. I. dipatirasa with likokain 2%. the former incision is closed with tensoplas (band aid). iii.

e. ii.25 mg estrogen estinilestradiol equin conjugate for 14-21 days. If there is no pus infection. unplug and plug the new implant. install a new capsule 1 piece at a different insertion site. ii. and whether there are signs of local infection insertion. ii. d. iii. wash with soap and water or antiseptic. Infection in the insertion area i. Give appropriate antibiotic for 7 days. Implants should not be removed and clients were asked to return one week. . Weight up / down i. If the weight change is unacceptable. If there is no infection and other capsules were still in place. and stream incision pus out. give 2 tablets pill combination for 3-7 days and then followed by one cycle of the combination pill. If found abscess. Pull the capsule expulsion. On the other side of the arm or find another method of contraception. Review the client if there is a change diet weight 2 kg or more. iii. iv. clean with antiseptic. remove the implants do wound care and oral antibiotics given 7 days. or encourage clients to use another contraceptive method. Inform the client that changes in body weight 1-2 kg is normal. If there is bleeding more than usual. If not improved. or it can also be given 50 mg or 1. Ekspulasi i. check whether another capsule is still in place. c.iv. help clients look for other methods. If there is infection around the capsule existing unplug and plug the new capsule on the other arm.