Immediate vs Delayed Postpartum Implanon-NXT

This prospective observational cohort study aims to compare immediate postpartum insertion (within 72 hours after delivery) versus delayed insertion (4-6 weeks postpartum) of the etonogestrel subdermal implant (Implanon-NXT®️) regarding side effects, bleeding patterns, implant-related complications, breastfeeding outcomes, continuation rates, and patient satisfaction. The study will be conducted at Assiut General Hospital and will include 100 postpartum women aged 18-45 years who delivered at term and chose Implanon-NXT®️ as their contraceptive method. Participants will be divided into two groups according to timing of insertion: immediate postpartum and delayed postpartum insertion. Baseline assessment will include detailed medical and obstetric history, clinical examination, complete blood count, coagulation profile, liver function tests, and breastfeeding evaluation. Implant insertion will be performed according to standard IMPLANON-NXT®️ guidelines under aseptic conditions by trained clinicians. Participants will be followed at 6 weeks, 3 months, 6 months, and 12 months after insertion. Follow-up evaluation will include assessment of bleeding patterns using WHO Belsey definitions, implant-site complications, breastfeeding status, side effects, continuation rates, unintended pregnancy, and patient satisfaction using a validated Likert-scale questionnaire. Laboratory investigations and transvaginal Doppler ultrasound of the uterine artery will also be performed during follow-up visits. Data will be analyzed using IBM SPSS version 29. Statistical significance will be considered at p \< 0.05. The study aims to provide evidence regarding the optimal timing of postpartum Implanon-NXT®️ insertion to improve contraceptive outcomes and patient satisfaction.