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

Abstract

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.