Uterine artery doppler indices may predict intrauterine contraceptive device-related abnormal uterine bleeding

Manu Agrawal; Seema Mehta; Neha Sharma; Shivangi Jain

doi:10.18203/2320-1770.ijrcog20221811

Authors

Manu Agrawal Department of Obstetrics and Gynaecology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Seema Mehta Department of Obstetrics and Gynaecology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Neha Sharma Department of Obstetrics and Gynaecology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan, India
Shivangi Jain Department of Obstetrics and Gynaecology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221811

Keywords:

IUCDs, Abnormal uterine bleeding, Doppler ultrasound

Abstract

Background: The aim of the study was to assess the role of colour Doppler velocimetry of the uterine arteries as a predictor of intrauterine contraceptive devices (IUCD)-induced abnormal uterine bleeding.

Methods: A prospective study was performed on 120 women (60 without AUB and 60 with AUB) who had copper IUCD inserted as a method of contraception. Detailed history, general and local examination and relevant investigations were done. Pulsatility index (PI) and resistance index (RI) of uterine artery measured at 3 months after IUCD insertion.

Results: Cut-off levels for PI and RI of uterine arteries were set. PI cut-off level <2.09 with sensitivity of 58.3%, specificity of 61.67% and area under the curve (AUC) of 0.666. RI cut-off level ≤0.83 with sensitivity of 53.33%, specificity of 66.67% and AUC of 0.703. These cut-off levels were associated with abnormal uterine bleeding.

Conclusions: Initial measurement of uterine artery Doppler indices (PI and RI) before IUCD insertion could be useful in predicting IUCD-induced abnormal uterine bleeding which is the major cause of method withdrawal during the first year of use and accordingly women could be counseled to consider another method of contraception.

Metrics

Metrics Loading ...

References

Marret H, Fauconnier A, Chabbert-Buffet N, Cravello L, Golfier F, Gondry J, et al. Clinical Practice Guidelines on Menorrhagia: Management of Abnormal Uterine Bleeding before Menopause. Euro J Obstetr Gynecol Reproduct Biol. 2010;152(2):133-7.

Mansour GM, Hussein SH, Mohammed HF, El Mekkawy SF, Akl SA, Abd El Dayem AA. Can We Predict Menorrhagia with Intrauterine Contraceptive Device (IUCD) Insertion? Open J Obstetr Gynecol. 2017;7(7):753-66.

Azkoul Z, Abdel-Azeem S, Nassif A and Sharaf A. Role of Uterine Artery Doppler in Assessment of Abnormal Uterine Bleeding in Females Using Copper Contraceptive Intrauterine Device. Med J Cairo University. 2017;85(8):3029-36.

De Souza MA, Geber S. Doppler color flow analysis of the uterine arteries before and after intrauterine device insertion: a prospective study. J Ultrasound Med. 2006;25(2):153-7.

El-Mazny A, Abou-salem N, Elshenoufy H. Three-dimensional power Doppler study of endometrial and subendometrial micro vascularization in women with intrauterine device-induced menorrhagia. Fertility Sterility. 2013;99(7):1912-5.

Jiménez MF, Vetori D, Fagundes PP, De Freitas FM, Cunha-Filho JL. Subendometrial Micro vascularization and Uterine Artery Blood Flow in IUD-Induced Side Effects (Levonorgestrel Intrauterine System and Copper Intrauterine Device). Contraception. 2008;78(4):324-7.

Attia AM, Radwan MEH, Elwan YA, Saleh HSA. Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device. Obstet Gynecol Sci. 2021;64(3):309-16.

Rezk M, Elkelani O, Gaber W, Shawky M. Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding. Middle East Fertility Society J. 2018;23(4):496-500.

Mutlu I, Demir A, Mutlu MF. Can uterine artery Doppler parameters predict copper intrauterine device-induced side effects? Euro J Contracept Reproduct Health Care. 2014;19(1):51-6.