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186985

Can pre-insertion uterine artery Doppler indices predict intrauterine contraceptive device-related heavy menstrual bleeding?

Article

Last updated: 22 Jan 2023

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Abstract

Background: The intrauterine contraceptive device (IUCD) is a frequently used method of contraception all-over the world. The most common side effect of IUCD is menorrhagia which is accountable for increased removal rate in the first year of its use. Objective: To test the hypothesis that initial uterine artery pulsatility index (PI) and resistance index (RI) before insertion of Tcu 380A IUCD could predict IUCD-related heavy menstrual bleeding or not. Methodology: A cohort study was performed on 300 women who demanded copper IUCD insertion as a method of contraception. Full history, detailed examination and investigations were done. Hemoglobin (Hb) concentration and PI and RI of uterine artery were measured using voluson B6 equipment before IUCD insertion and 3 and 6 months after insertion. Results: 162 participants who suffered from heavy menstrual bleeding (group II) had significantly lower uterine artery PI and RI than 138 participants who did not suffer from heavy menstrual bleeding (group I) before IUCD insertion and 3 and 6 months after insertion (p-value < 0.001). Uterine artery Doppler indices showed no statistically significant changes after insertion of IUCD in each separate group (p-value > 0.05). 64 participants in group II with severe heavy menstrual bleeding required removal of the IUCD at the 3 months follow up visit. A cut-off levels for Doppler indices of uterine artery were PI ≤1.52 and RI ≤0.66. Conclusion: PI and RI of uterine artery are lower in patients with IUCD-induced heavy menstrual bleeding before IUCD insertion. Initial measurement of Doppler indices of uterine artery could predict IUCD-related heavy bleeding.

DOI

10.21608/jram.2021.54112.1105

Keywords

Copper intrauterine contraceptive device, heavy menstrual bleeding, uterine artery doppler indices

Authors

First Name

Marwa

Last Name

Ibrahim

MiddleName

A

Affiliation

1Obstetrics and Gynecology Department, El-Shiekh Zayd Al-Nahyan Hospital, Cairo, Egypt.

Email

marwa.unique@gmail.com

City

cairo

Orcid

-

First Name

Naglaa

Last Name

Mohammed

MiddleName

H

Affiliation

Obstetrics and Gynecology Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Email

profnaglaa.hussein@gmail.com

City

cairo

Orcid

-

First Name

Hala

Last Name

Abdel Halim

MiddleName

W

Affiliation

Obstetrics and Gynecology Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Email

hala_waheed520@yahoo.com

City

Cairo

Orcid

-

Volume

2

Article Issue

2

Related Issue

26940

Issue Date

2021-07-01

Receive Date

2020-12-20

Publish Date

2021-07-01

Page Start

184

Page End

193

Print ISSN

2636-252X

Online ISSN

2636-2538

Link

https://jram.journals.ekb.eg/article_186985.html

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https://jram.journals.ekb.eg/service?article_code=186985

Order

7

Type

Original Article

Type Code

676

Publication Type

Journal

Publication Title

Journal of Recent Advances in Medicine

Publication Link

https://jram.journals.ekb.eg/

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Article

Created At

22 Jan 2023