Professor Atiene Solomon Sagay - University of Jos Institutional ...

We studied the effects of Norplant® on the electrical activity of the heart and showed a
tendency to significant prolongation of ECG intervals (a tendency to cause heart blocks)
(Sagay et al 2002, Okeahialam et al 2004). Although these ECG changes appeared
innocuous, we advised that patients with pre-morbid cardiac conditions should use alternative
contraceptives until these effects are clearly elucidated. Norplant® did not show any
adverse effects on diastolic and systolic blood pressures over time.
Of additional note are the findings that Norplant use is associated with the depletion of
platelet counts (Aisien et al 2002), weight gain after 2 years of use (Sagay et al 2008 ) and
mild but reversible impairment of glucose metabolism (Sagay et al 2000).
The effect of Norplant® use on the bone quality of Nigerian women using quantitative
ultrasound measurements and serum markers of bone turnover (VanderJagt et al 2005)
We used calcaneal ultrasound to compare the bone quality of Nigerian women between 25
and 50 years of age who had Norplant implants for 1-4 years to that of women who were not
using any form of hormonal contraceptive. The mean stiffness index of women who had
Norplant implants for as long as 4 years was not significantly different from that of controls.
However, serum markers of bone turnover were significantly decreased in women with
Norplant implants compared to age-matched controls. Serum bone-specific alkaline
phosphatase was significantly decreased in subjects with Norplant implants for 1 year and
serum N-Telopeptidase was significantly decreased in subjects with implants for 3 years. We
conclude that although levonorgestrel contraceptive decreased overall bone turnover, it had
no deleterious effect on the bone quality of women using Norplant implants for up to 4 years.
(VanderJagt et al 2005).
Overall, Norplant® use in our women was not associated with any serious adverse effects.
Contraceptive implants have remained popular in our family planning clinics today.
3. How hazardous can pregnancy and childbirth be?
If a mother dies, the infant has little chance of survival
Maternal mortality: This is defined as the death of a woman while pregnant or within 42 days
of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any
cause related to or aggravated by the pregnancy or its management, but not from accidental or
incidental causes.
Worldwide, every minute a woman dies from pregnancy-related complications.
Maternal mortality ratio: The number of maternal deaths per 100,000 live births.
The maternal mortality ratio in Nigeria is 545 deaths per 100,000 live births. (NDHS 2010)
Maternal morbidity: Refers to serious disease, disability or physical damage such as fistula,
caused by pregnancy-related complications.
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