Assessment of Heavy Menstrual Bleeding Related to Copper IUCD Using Uterine Artery Doppler Indices: Pulsatility Index and Resistance Index | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 124, Volume 100, Issue 1, July 2025, Pages 3415-3421 PDF (405.61 K) | ||
| DOI: 10.21608/ejhm.2025.445875 | ||
| Abstract | ||
| Background: The copper intrauterine contraceptive device (IUCD) is a widely used long-acting reversible contraceptive method. However, one of its major drawbacks is the induction of heavy menstrual bleeding (HMB), which may lead to iron deficiency anemia (IDA) and result in early device removal. Uterine artery Doppler parameters, such as the resistance index (RI) and pulsatility index (PI), have been investigated as potential predictors of HMB in IUCD users. Objective: This study aimed to assess HMB related to the insertion of a copper IUCD through uterine artery Doppler indices, focusing on PI and RI, both at baseline and after 3 months of use. Patients and methods: This prospective observational study was conducted on 30 women who underwent copper IUCD insertion. Uterine artery Doppler indices—RI and PI—were measured via transvaginal ultrasound both before IUCD insertion and three months afterward. Participants were monitored clinically for signs of HMB using standardized bleeding scores and questionnaires. Results: The study observed a significant reduction in uterine artery RI and PI in patients who developed HMB three months after IUCD insertion. A strong inverse correlation was found between Doppler indices and the severity of menstrual bleeding. Baseline Doppler indices were also predictive of HMB, with ROC analysis demonstrating satisfactory diagnostic performance. Conclusions: It could be concluded that uterine artery Doppler indices, particularly PI and RI, serve as useful non-invasive predictors for the development of HMB following copper IUCD insertion. Early identification of at-risk patients may facilitate individualized contraceptive counseling and management. | ||
| Keywords | ||
| Copper IUCD; HMB; Pulsatility Index; Resistance Index; Uterine Artery Doppler; Transvaginal Ultrasound | ||
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