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

Manu Agrawal, Seema Mehta, Neha Sharma, Shivangi Jain


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.



IUCDs, Abnormal uterine bleeding, Doppler ultrasound

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