This study will investigate in-office ultrasound localization vs localization in radiology for identification and removal of non palpable etonogestrel (ENG) contraceptive implants and aims to help establish best practices in this domain. Investigators will also create an ultrasound image gallery of palpable and non palpable as well as instructional video for non palpable ENG implant removal.
This is a descriptive study to establish best practices for ENG implant localization and non-palpable ENG implant removal. Women presenting to UCLA Obstetrics and Gynecology service for ENG non-palpable and palpable implant removal or with ENG implant in place but desiring continuation will be enrolled. Investigators aim to enroll 20 women in each group. Screening data will be reviewed to determine subject eligibility. Subjects who meet all inclusion criteria will be entered into the study. Study duration for each participant is one visit for continuation group and two weeks for group desiring implant removal. Total study duration is expected to be 18 months. 1. For women desiring implant removal: document ENG implant using in-office imaging of ENG implant in the FP clinic with standard ob/gyn office ultrasound (abdominal 15 MHz linear probe with color doppler) and the same, using high frequency vascular probe (20+ MHz) in the radiology department. 2. Create an image gallery of office and radiology department obtained images of ENG implant localization. This will include: 1. Ultrasound images obtained in women with palpable or non-palpable ENG implants in place at various time intervals after insertion who desire ENG implant continuation (office imaging only). 2. Ultrasound images obtained in women seeking removal of non-palpable ENG implants, primarily referred patients who have either failed outside implant removal or have a non-palpable implant on presentation for removal. 3. Document and describe all cases of non palpable ENG implant removal with standard, in-office US versus radiology ultrasound equipment. Investigators will collect radiographic images, clinical findings, instruments used, patient characteristics (BMI, weight gain, time since of insertion), success of procedure, duration of procedure, number of attempts, final location of implant, and need for referral to general or vascular surgeon.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
40
the researcher(s) will ask you to: Visit 1 - SCREENING VISIT * questions about your medical/contraception history * Review medical record * physical examination * urine sample for pregnancy test Visit 2a - Radiology * Have an ultrasound of your arm * The radiologist will mark your arm at the location of the implant. Visit 2b * ultrasound of your arm to locate the implant. This is done by feeling the area. * Have your ENG implant removed through a numbed small cut. The researcher will apply a pressure bandage to the site(s). This will reduce bleeding/decrease swelling. * Have the removal procedure video recorded. Visit 3 - FOLLOW UP VISIT approximately 2 weeks after Visit 2: * Provide a urine sample for pregnancy test * Have the implant removal site examined
the researcher(s) will ask you to: * To answer questions about your medical and contraception history * Review your medical record * Have a physical examination by the researcher * Provide a urine sample for pregnancy test * Have an ultrasound of your arm
UCLA Dept. OB/GYN, Women's Health CRU, 10833 Le Conte Ave, CHS 22-265
Los Angeles, California, United States
Creation of image gallery
Creating an image gallery in order to locate ENG implant using ultrasound and radiological images
Time frame: 18 months
Creation of an instructional video and reference guide for ENG implant removal.
If ultrasound/radiological images are successful at locating ENG implant, this data could lead to the creation of a reference guide for other providers.
Time frame: 18 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.