Subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects (levonorgestrel intrauterine system and copper intrauterine device).
BACKGROUND
A better understanding of the uterine and endometrial vascularization in intrauterine device (IUD)-induced side effects is clearly of paramount importance in terms of both physiological and pathophysiological changes and may permit assessment for future therapeutic treatments. The aim of the study was to quantify the subendometrial microvascularization and uterine artery blood flow in IUD-induced side effects using power Doppler analysis as well as pulsatility index (PI) and resistance index (RI) in the exact midluteal phase 3 months after IUD insertion. There were 27 patients using the levonorgestrel-releasing intrauterine system and 25 patients using TCu 380A.


METHODS
This study has a prospective clinical trial design.


RESULTS
There is an increased subendometrial blood flow in patients with severe dysmenorrhea and/or bleeding, after controlling for IUD type, age and parity. Moreover, the PI and RI were not different in such women.


CONCLUSIONS
The results provide new data on the bleeding patterns related to these IUD types that may be relevant during contraception use. This method could be used as a prognostic factor to better evaluate women for the risk of developing dysmenorrhea and/or bleeding after IUD insertion.
Programa de Pós-graduação em Medicina: Ciências Médicas, Faculdade de Medicina, 90035-003 UFRGS, Brazil.
Mirela F
MF
Jiménez
Daniela
D
Vetori
Paulo A P
PA
Fagundes
Fernando M
FM
de Freitas
João S L
JS
Cunha-Filho
D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D001158:Arteries / Q000000981:diagnostic imaging; D004412:Dysmenorrhea / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D005260:Female; D018056:Hemorheology; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D008595:Menorrhagia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D055806:Microvessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*