Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding
Objective: To test the hypothesis whether initial uterine artery pulsatility index (PI) and resistance index (RI) before insertion of copper-T 380 intrauterine contraceptive device (IUCD) could predict IUCD-related heavy menstrual bleeding or not. Methods: This prospective observational study was co...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2018-12-01
|
| Series: | Middle East Fertility Society Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S111056901730242X |
| _version_ | 1818808608050118656 |
|---|---|
| author | Mohamed Rezk Osama Elkelani Wael Gaber Mohamed Shawky |
| author_facet | Mohamed Rezk Osama Elkelani Wael Gaber Mohamed Shawky |
| author_sort | Mohamed Rezk |
| collection | DOAJ |
| description | Objective: To test the hypothesis whether initial uterine artery pulsatility index (PI) and resistance index (RI) before insertion of copper-T 380 intrauterine contraceptive device (IUCD) could predict IUCD-related heavy menstrual bleeding or not. Methods: This prospective observational study was conducted on 332 women who requested insertion of copper IUCD. Uterine artery PI and RI were measured before insertion and repeated at 3 and 6 months after IUCD insertion. Participants were divided into two groups according to their menstrual calendar and hemoglobin concentration; Normal bleeding group (n = 188) and heavy menstrual bleeding group (n = 144). Receiver-operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of uterine artery PI and RI in prediction of IUCD-related heavy menstrual bleeding. Results: Uterine artery Doppler indices does not show significant change 3 and 6 months after IUCD insertion in both groups (p > .05). Uterine artery PI < 1.5 was associated with heavy menstrual bleeding after IUCD insertion (sensitivity 82% and specificity 90%, with area under the curve, AUC of 0.92 and p-value <.001). Also, uterine artery RI < 0.65 was associated with heavy menstrual bleeding after IUCD insertion (sensitivity 80% and specificity 90%, AUC 0.91 and p-value <.001). Conclusion: Initial uterine artery Doppler studies could be beneficial as a predictor of IUCD related heavy menstrual bleeding and should be implemented during counseling of women desiring long acting reversible contraception. Keywords: Intrauterine contraceptive device, Heavy menstrual bleeding, Uterine artery Doppler, Pulsatility index, Resistance index |
| first_indexed | 2024-12-18T19:44:15Z |
| format | Article |
| id | doaj.art-d5c57728053f4f9b998431347e4b2438 |
| institution | Directory Open Access Journal |
| issn | 1110-5690 |
| language | English |
| last_indexed | 2024-12-18T19:44:15Z |
| publishDate | 2018-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Middle East Fertility Society Journal |
| spelling | doaj.art-d5c57728053f4f9b998431347e4b24382022-12-21T20:55:21ZengSpringerOpenMiddle East Fertility Society Journal1110-56902018-12-01234496500Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleedingMohamed Rezk0Osama Elkelani1Wael Gaber2Mohamed Shawky3Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt; Corresponding author at: 25 Yasin Abdelghafar Street, Shibin ElKom City, Menoufia Governorate, Egypt.Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, EgyptDepartment of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, EgyptDepartment of Radiology, Faculty of Medicine, Menoufia University, EgyptObjective: To test the hypothesis whether initial uterine artery pulsatility index (PI) and resistance index (RI) before insertion of copper-T 380 intrauterine contraceptive device (IUCD) could predict IUCD-related heavy menstrual bleeding or not. Methods: This prospective observational study was conducted on 332 women who requested insertion of copper IUCD. Uterine artery PI and RI were measured before insertion and repeated at 3 and 6 months after IUCD insertion. Participants were divided into two groups according to their menstrual calendar and hemoglobin concentration; Normal bleeding group (n = 188) and heavy menstrual bleeding group (n = 144). Receiver-operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of uterine artery PI and RI in prediction of IUCD-related heavy menstrual bleeding. Results: Uterine artery Doppler indices does not show significant change 3 and 6 months after IUCD insertion in both groups (p > .05). Uterine artery PI < 1.5 was associated with heavy menstrual bleeding after IUCD insertion (sensitivity 82% and specificity 90%, with area under the curve, AUC of 0.92 and p-value <.001). Also, uterine artery RI < 0.65 was associated with heavy menstrual bleeding after IUCD insertion (sensitivity 80% and specificity 90%, AUC 0.91 and p-value <.001). Conclusion: Initial uterine artery Doppler studies could be beneficial as a predictor of IUCD related heavy menstrual bleeding and should be implemented during counseling of women desiring long acting reversible contraception. Keywords: Intrauterine contraceptive device, Heavy menstrual bleeding, Uterine artery Doppler, Pulsatility index, Resistance indexhttp://www.sciencedirect.com/science/article/pii/S111056901730242X |
| spellingShingle | Mohamed Rezk Osama Elkelani Wael Gaber Mohamed Shawky Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding Middle East Fertility Society Journal |
| title | Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding |
| title_full | Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding |
| title_fullStr | Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding |
| title_full_unstemmed | Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding |
| title_short | Pre-insertion uterine artery Doppler indices may predict intrauterine contraceptive device-related heavy menstrual bleeding |
| title_sort | pre insertion uterine artery doppler indices may predict intrauterine contraceptive device related heavy menstrual bleeding |
| url | http://www.sciencedirect.com/science/article/pii/S111056901730242X |
| work_keys_str_mv | AT mohamedrezk preinsertionuterinearterydopplerindicesmaypredictintrauterinecontraceptivedevicerelatedheavymenstrualbleeding AT osamaelkelani preinsertionuterinearterydopplerindicesmaypredictintrauterinecontraceptivedevicerelatedheavymenstrualbleeding AT waelgaber preinsertionuterinearterydopplerindicesmaypredictintrauterinecontraceptivedevicerelatedheavymenstrualbleeding AT mohamedshawky preinsertionuterinearterydopplerindicesmaypredictintrauterinecontraceptivedevicerelatedheavymenstrualbleeding |