Transvaginal Spectral Doppler Analysis of Uterine Artery pre- and post-Copper Intrauterine Contraceptive Device (Cu-IUCD) Insertion to Predict Heavy Menstrual Bleeding.

Background: Cu-IUCD is the most common method for long-acting reversible contraception, but its high potential use is hampered by menstrual complications especially heavy menstrual bleeding. So our work aimed to study the effect of Cu-IUCD on uterine artery blood flow through the assessment of uterine artery indices using transvaginal Doppler ultrasound (TVDU); and whether those potential findings could predict the risk of bleeding before insertion. Methods: This prospective observational study had performed on 100 women in the Department of Obstetrics and Gynecology, Zagazig University Hospitals who requested insertion of a Cu- IUD for contraception and who met the inclusion criteria. Pulsatility (PI) and resistance index (RI) of the uterine artery were measured just before, three, and six months post-insertion. Results: Forty-eight women came complaining of heavy menstrual bleeding and another 52 women were regularly menstruating. There was a substantial statistical variation concerning PI, and RI among women with IUD-induced heavy menstrual bleeding (n = 48) and those with the normal menstrual cycle (n = 52), while there was no difference as regards age, and abortion (P < 0.05). Uterine artery RI = 0.809 and PI = 2.078 was correlated with significant menstrual bleeding following insertion of IUCD. Conclusions:Our results endorse our assumption that vascular changes may represent a critical part in the occurrence of heavy menstrual bleeding, so a study of TVDU of the uterine artery indices is a valuable adjuvant indicative means to predict the abnormal uterine bleeding for women pursuing the use of Cu-IUCD and lead to the proper choice for contraception and decrease the complications as possible. [ABSTRACT FROM AUTHOR]