Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device

• Published in: Obstetrics & gynecology science Vol. 64; no. 3; pp. 309 - 316
• Main Authors: Attia, Alaa Mohamed, Radwan, Mohammed El-Husseiny, Elwan, Yousef Abo, Saleh, Hend Salah Abdo
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Obstetrics and Gynecology 01.05.2021
• Subjects: copper intrauterine contraceptive device; Original; pulsatility index and resistance index; transvaginal doppler ultrasound; Copper intrauterine contraceptive device; Pulsatility index and resistance index; Transvaginal Doppler ultrasound
• ISSN: 2287-8572; 2287-8580
• DOI: 10.5468/ogs.20349

To assess the predictive value of the initial uterine artery Doppler indices, the pulsatility index (PI), and resistance index (RI) in the prediction of heavy menstrual bleeding before and after copper intrauterine contraceptive device (IUCD) insertion. The current prospective clinical study included 100 women who intended to use a copper IUCD (Cu T-380A) and met the inclusion criteria. Uterine artery Doppler PI and RI indices were calculated before IUCD insertion and at three and six months after insertion. Based on the presence or absence of menorrhagia, all women were classified into two groups: non-bleeding (n=52) and extreme menstrual bleeding (n=48). Receiver operating curve analysis was used to determine the predictive value of uterine artery PI and RI in patients with menorrhagia relevant to IUCD. The PI and RI indices displayed a highly significant difference between the IUCD groups at three and six months after insertion (P<0.001). Uterine artery PI ≤2.02 (sensitivity of 95.8%, specificity of 100%, and area below the curve [AUC] of 0.97 at P-value<0.001) and RI ≤0.83 (sensitivity of 93.8%, specificity of 100%, and AUC of 0.949 at P-value<0.001) were correlated with significant menstrual bleeding following insertion of IUCD. The presented results confirmed our assumption that the initial studies of uterine artery Doppler can predict heavy-menstrual bleeding associated with IUCD and therefore, should be conducted in women pursuing reversible longacting contraception.