TRANSVAGINAL ULTRASOUND DOPPLER ASSESSMENT OF SUBENDOMETRIUM BLOOD FLOW IN CASES OF EXCESSIVE MENSTRUAL BLEEDING AFTER INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 3, Pages 4627-4634
AbstractBackground: The intrauterine contraceptive device (IUCD) is one of the most used methods of contraception all over the world. The most important adverse effects related to copper intrauterine contraceptive device use are excessive uterine bleeding and menstrual pain. This study aimed to evaluate uterine artery and subendometrial blood flow in patients who are complaining of excessive menstrual bleeding after IUCD insertion. Patients and methods: Fifty-four women were included in this cross sectional case control study and they divided into group I (18 women) using copper intrauterine device (Tcu 380A) and complaining of menorrhagia; group II (18 women) using copper IUCD and not complaining of abnormal uterine bleeding and group III (18 women) who not using any contraceptive method and not complaining of abnormal uterine bleeding. Results: There is statistically significant difference between the studied groups regarding subendometrial RI and PI. On doing Turkey’s HSD test, the difference is significant between group with IUD and manifested by excessive menstrual bleeding and the group with IUD and normal menstrual flow and control groups. RI was significantly higher in those with IUD and excessive menstrual flow and patients within this group had the lowest PI. The best cutoff of uterine PI in prediction of excessive menstrual bleeding if IUD inserted is ≤1.85 with area under curve 0.936, at which sensitivity 88.9%, specificity 88.9%, positive predictive value 94.1%, negative predictive value 80% and accuracy 88.9% (p<0.05).Conclusion: Uterine artery and subendometrial blood flow were increased in women with IUCD induced menorrhagia in comparison to women with copper IUCD and not complaining of abnormal bleeding and women without copper IUCD.
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