Insertion of Norplant by midwives and physicians: comparative cohort study
Siswosudarmo, R.
Berkala Ilmu Kedokteran 23(4): 121-126
1991
ISSN/ISBN: 0126-1312 PMID: 12318376 Document Number: 329014
A comparative cohort study on the insertion of Norplant by midwives and physicians had been carried out to compare its safety. A total of 500 acceptors participated in the study, 292 of whom belonged to the group of midwives and 202 to the physicians group. They came from suburban areas surrounding the city of Yogyakarta, Indonesia. Although both groups were statistically different in terms of age and body weight, they were not so clinically. Norplant was delivered outside the hospital during the mass campaign (safari susuk), but standardized hospital asepsis was taken. Follow-up was done 1 week thereafter to detect the presence of complications or side effects, such as pain, inflammation, abscess and sense of itching. The statistical analyses used in this study were the t-test, chi-square test, and relative risk. Results showed that midwives inserted Norplant more rapidly compared to physicians (2.36 vs. 3.45 minutes, respectively), although it did not have clinical importance. 23.6% of the cases among the midwife group showed a variety of complications while that of the physician group was 19.7%, the relative risk being 1.20 (0.82-1.75). More detailed complications such as pain, inflammation, abscess, and itching did not show significant difference. The risk of complication in all cases was influenced by neither the duration of insertion nor by the level of education. The study concluded that midwives could insert Norplant as safely as physicians.