Transvaginal ultrasonography and color Doppler in female patients complaining of menorrhagia and using copper intrauterine contraceptive device

Document Type : Original Article

Authors

Obstetrics and Gynecology department, Faculty of Medicine, Beni-Suef University, Egypt

Abstract

The goal of this study is to evaluate the correlation between abnormal uterine bleeding in IUD users and the position of IUD, uterine size, endometrial thickness, uterine artery Doppler [pulsitility index (PI); Resistivity index (RI)] using transvaginal ultrasound and Doppler.

100 women divided into two groups (50) women who have been using an IUD for at least 6 months, and experienced symptoms after placement of IUD in the form of menorrhagia may be in the form of increase in the amount and/or duration of the menstruation and (50): women who have been using an IUD for at least 6 months, and did not experience menorrhagia after insertion of IUD.

There is a possible relationship between the IUD location inside the uterine cavity and the abnormal uterine bleeding among IUD users.  The higher the position of the IUD, the less the frequency of abnormal uterine bleeding associating the IUD, the IUD-F, IUD-M, IUD-E and IUD-IO distances may be utilized as good predictors for the IUD location inside the uterus. The PI and RI were significantly lower in women with IUD-induced menorrhagia than in those using IUD without complaining of menorrhagia.

Keywords

Main Subjects

References

  1. Carvalho N.S., Botelho A.B., Mauro D.P., et al.(2016) : Sexually Transmitted Infections, Pelvic Inflammatory Disease, and the role from Intrauterine Devices: Myth or fact? J. Biomedical. Sci., 6: 1.
  2. Li X, Wei M, Lin TC, et al. (2013): A comparison of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of adhesion reformation following hysteroscopic surgery for Asherman syndrome: a cohort study. Eur J ObstetGynecolReprodBiol 170: 512-516.
  3. Schiesser M, Lapaire O, Tercanli S, et al.( 2004) : Lost intrauterine devices during pregnancy: maternal and fetal outcome after ultrasound-guided extraction. An analysis 82 of cases. Ultrasound in Obstetrics & Gynecology; 23(5):486-9.
  4. WHO (2010): The width of the uterine cavity is narrower in patients with an embedded intrauterine device (IUD) compared to a normally positioned IUD. Journal of Ultrasound in Medicine; 29(10):1453-6.
  5. Johnson BA (2005): Insertion and removal of intrauterine devices. Am Fam Physician 71: 95-102.
  6. Forthofer K.V.(2009): A clinical review of the intrauterine device as an effective method of contraception". J. Obstet. Gynecol. Neonatal. Nurs., 38 (6): 693-8.
  7. Sivin I. and Batar I.(2010): State-of-the-art of non-hormonal methods of contraception: III. Intrauterine devices. Eur. J. Contracept. Reprod. Health Care, 15 (2): 96-112.
  8. Waleed E, Sleet ME and Mahdi EY (2011): Comparative study of transvaginal sonography and hysteroscopy for the detection of pathological endometrial lesions in women with perimenopausal bleeding. Middle East Fertility Society Journal; 16(1):77-82.
  9. Hubacher D., Chen P.L. and Park S. (2009): Side effects from the copper IUD: Do they decrease over time? Con-traception, 79 (5): 356-62.
  10. Baldszti E., Wimmer B.,  Loscchke K., (2003) : acceptability of the long term contraceptive levonorgestrel releasing intrauterine system, a 3  years follow up study, contraception  67:87.
  11. Hurskainen R, Teperi J, Rissanen P, Aalto A-M, Grenman S, Kivelä A. Kujansuu E, Vuorma S, Yliskoski M and Paavonen J (2004) : Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia. JAMA 291:1456–1463.
  12. Habara T, Nakatsura M, Konishi H, Asagiri K, Noguchi S, Kudo T. (2002) Elevated blood flow resistance in the uterine arteries of women with unexplained recurrent pregnancy loss. Hum Reprod. ;17:190–195 .
  13. Momtaz M, Zayed M, Rashid K, et al (1994) : Doppler study of the uterine artery in patients using an intrauterine contraceptive device. Ultrasound ObstetGynecol 1994;4:231.
  14. Shimoni N. (2010) : Intrauterine contraceptives: A review of  uses, side effects, and candidates. Semin. Reprod. Med., 28 (2): 118-25.  
  15. Pinter B. (2002): Continuation and compliance of contraceptive  use Eur. J. Contracept. Reprod. Health Care, 7: 178-83.  
  16. Lockwood C.J. (2011): Mechanisms of normal and abnormal endometrial bleeding. Menopause, 18 (4): 408-11.
  17. Kupesic  and Kurjak A. (2005 ): Uterine blood flow in  fertile and infertile women. In: Schmidt W., Kurjak A., editors. Color Doppler sonography in gynecology. Stuttgart: Georg. Thieme. Verlag, p. 36.  
  18. Faundes D, Bahmondes L, Faundes A, Petta C, Diaz J and Marchi N (1997): No relation between the intrauterine contraceptive device position evaluated by ultrasound and complaints of bleeding and pain. Contraception 56: 43-47.
  19. Zhang J (1993): Factors associated with copper T IUD for removal due to bleeding/pain. Contraception 48(1): 13-21.
  20. Faundes D, Perdigao A, Faundes A, Bahamondes L, Petta CA. (2013): T-shaped IUDs accommodate in their position during the first 3 months after insertion.Contraception;62(4)165-8
  21. Abdel Aleem H.A., Kamel H.S, and Aboul-oyoun M.(2012): Role of ultrasonography in managing intrauterine contraceptive device related complications. Contraception; 46:211-220.
  22. Pakarinen P, Suvisaari J and Luukkainen T (1994): Intracervical and fundal administration of Levonorgestrel for contraception: endometrial thickness,patterns of bleeding and persisting ovarian follicles. Fertil and Steril 68(1): 9-64.
  23. Frajndlich R, von Eye Corleta H, Frantz N. (2012): Color Doppler sonographic study of the uterine artery in patients using intrauterine contracetivedevices.J Ultrasound Med ; 19(8): 577-9.
  24. Usama MF, Dalia Y, Hassan M.( 2010) Uterine artery blood flow in patients with copper intrauterine device-induced abnormal uterine bleeding. Middle East Fertility Society Journal 2010; 15:168-73.
  25. Amal A, Manal B, Amal N. )2010) Does uterine artery Doppler or copper IUD location by 3D trans-vaginal ultrasound correlates with clinical symptoms. Webmed Central Obstetrics and Gynecology 2010; 1(9): WMC00702.
  26. Ebru Coskun, Yigit Cakiroglu, Banu K.A., Bahar M. et al. (2011). Effect of copper intrauterine device on the cyclooxygenase and inducible nitric oxide synthase expression in the luteal phase endometrium. Contraception 2011;84(6):637-41
  27. Evans T (2005): The physics of Doppler Ultrasound and Doppler Equiment. In: Chydleigh T., Thilaganathan B (eds). Obstetric Ultrasound How, Why and When.Third Edition.Elseiver, Ch15, P209:221.
  28. Jamenez MF., Arbo E., Vetori D et al. (2008): The effect of the levonorgestrel releasing intrauterine system and the copper intrauterine device on subendometrial microvascularization and uterine artery blood flow. Fertil. Steril: 90(5):1574:8.
  29. Nuray Y., Mahmut K. and Ugur K. (2009): Department of Radiology, Ankara Training and Research Hospital, Cebeci. TR-06340, Ankara, Turkey, 2009.  
  30. Iknur Mutlu, Ahmet Demir, Memmet Firat, (2014) .: Can uterine artery Doppler parameters predict copper intrauterine device-induced side effects the European Journal of Contracept. Reprod. Health Care, 19 (1):  51-6.  
  31. El-Mazny Akmal, Nemeen Abou-Salem, Hossam Elsheoufy (2013). Three dimensional power Doppler study of endometrial and sub-endometrial micro vascularization in women with IUD-induced menorrhagia. Fertility Sterility 2013;99(7):1912-15
  32. Oshen A., Ben Chetrit EJ. Margalioth O.,Lavie RR., Rabinowitz (2008) : Effects of a copper-mediated intrauterine contraceptive device on ovarian artery, uterine artery, and intrauterine blood flow. GynecolObstet Invest; 66:253:256.
  33. Stubblefield PG., Carr-Ellis S., Kapp N (2007): Family Planning. In Berek JS, Berek & Novak’s Gynecology. Fourteenth Edition. Williams & Wilkins: 260:263.
Egyptian Journal of Medical Research
Volume 4, Issue 4
October 2023
Pages 7-33

Files

Share

How to cite

Statistics