Does Uterine Artery Doppler or Copper Intrauterine Device Location by Three Dimensional Transvaginal Ultrasound Correlates with Clinical Symptoms?,AMAL M. AL-ANWAR, MANAL EL-BEHERY, AMAL NOH and BADEEA S. SOLIMAN
Abstract
Aim of Study: Evaluation of using 3Ds ultrasound in location of intrauterine copper T 380 A IUD and Doppler uterine artery study in patients complaining of vaginal bleeding and pain.
Methods: This cross sectional study was conducted in Zagazig University Hospital, Obstetrics & Gynecology de-partments, 3D transvaginal ultrasound examinations were carried out to 180 women whom inserted the IUD 6-12 months duration. Seventy women were suffering from pain (group I) and forty four complaining of menorrhagia (group II) compared to sixty six control women (group III). Measurements were defined as the distance between top of the IUD and inner endometrium (IUD-E) as well as IUD and myometrium at the fundus (IUD-M), IUD and fundus (IUD-F) and lastly the distance between the ends of IUD and the sidewall of uterus (IUD-S). Doppler uterine artery pulsitilty index was measured in all women.
Results: No statistical significant differences were found between the three groups as regards IUD-E, IUD-M, IUD-F and IUD-S. Mean uterine artery pulsitility index was signifi-cantly lower in women suffering from pain with IUD than women with menorrhagia; and both groups had lower mean pulsitility index than control group (2.1±1.0, 2.4±0.41, 2.6±0.8 respectively, p<0.05). Pulsitility index PI£1.5 could predict IUD complains with the sensitivity 71.1%, specificity 65.2%, positive predictive value 77.9%, negative predictive value 56.6% and accuracy 68.8%.
Conclusion: 3D ultrasound IUD site did not differ between IUD complaining and non complaining women but pulsitility index of uterine artery is lower in women with IUD and suffering from bleeding or pain.