Pregnancy with Contraceptive Implant

Initial Assessment

The Centers for Disease Control and Prevention recommends confirming the pregnancy with appropriate testing and establishing gestational age when pregnancy is confirmed in a patient with a contraceptive implant 1, 2
The patient should be counseled about her pregnancy options, including continuation or termination, as part of the initial assessment 1
Evaluation for ectopic pregnancy should be performed, though the risk is not increased with implants compared to IUDs 3

The American College of Obstetricians and Gynecologists recommends removing the implant as soon as possible if the patient desires to continue the pregnancy 1, 2
No evidence suggests that implant removal improves pregnancy outcomes, unlike IUDs where removal significantly reduces risks of spontaneous abortion, septic abortion, and preterm delivery 1, 3

The Centers for Disease Control and Prevention notes that IUD pregnancies carry substantial risks of spontaneous abortion, septic abortion, preterm delivery, and chorioamnionitis, which is not the case with implant pregnancies 1, 3, 5
IUD removal significantly improves outcomes when strings are visible, but this does not apply to implant pregnancies 1, 2, 3

The American College of Obstetricians and Gynecologists recommends that postpartum implant insertion can occur at any time, including immediately postpartum, if the patient desires future contraception after pregnancy 1, 6, 7
The implant is safe for breastfeeding women ≥1 month postpartum, according to the Centers for Disease Control and Prevention 1, 6
Postabortion insertion can be performed within the first 7 days, including immediately after abortion, as recommended by the Centers for Disease Control and Prevention 1, 6, 8