scholarly journals Doppler ultrasound for prediction of IUCD-induced heavy menstrual bleeding: a prospective cohort study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed S. Sweed ◽  
Khaled H. Swidan ◽  
Naira S. Ibrahim ◽  
Eman A. NasrElDin ◽  
Ihab A. Gomaa
Keyword(s):  
Power Doppler ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Flow Index ◽  
Contraceptive Device ◽  
Subsequent Increase ◽  
Diagnostic Characteristics ◽  
Intrauterine Contraceptive ◽  
Group A ◽  
Group B

Abstract Background Previous studies reported changes in the local vasoactive substance production within the endometrium with a subsequent increase in vascularity as a possible mechanism of intrauterine contraceptive device (IUCD)-induced heavy menstrual bleeding. This research investigates the role of power Doppler velocimetries of the uterine arteries, endometrium, and sub-endometrium vascularization as a predictor of IUCD-induced heavy menstrual bleeding. Results Endometrium flow index (FI) and vascularization flow index (VFI) significantly increased in both groups: women with heavy menstrual bleeding (group A) and women without heavy menstrual bleeding (group B), with significantly higher increase in group A. Endometrium VFI ≥ 0.18 had the highest significant diagnostic characteristics in the prediction of heavy menstrual bleeding, followed by sub-endometrium VI ≥ 3.75. Conclusion The results of this study suggest an increase in uterine blood flow in women with IUCD-induced menorrhagia. Endometrial and sub-endometrial Doppler vascular indices can be used for the prediction of IUCD-induced heavy menstrual bleeding.

scholarly journals A COMPARISON OF INTRACAESARIAN VERSUS INTERVAL PLACEMENT OF INTRAUTERINE CONTRACEPTIVE DEVICE

2020 ◽  
Vol 70 (6) ◽  
pp. 1776-81
Author(s):  
Uzma Gul ◽  
Sunarays Akhtar
Keyword(s):  
Controlled Trial ◽  
Intrauterine Contraceptive Device ◽  
Military Hospital ◽  
Contraceptive Device ◽  
Interval Group ◽  
Significant Difference ◽  
Intrauterine Contraceptive ◽  
Group A ◽  
Continued Use ◽  
Group B

Objective: To compare intracaesarian placement of intrauterine contraceptive device (IUCD) with interval placement at 6 weeks in terms of device expulsion and continued use at 6 months postpartum. Study design: Randomized controlled trial. Setting: Obstetrics and Gynecology Department, Combined Military Hospital Jhelum, Oct 2017 to Oct 2018. Materials and methods: 104 pregnant women aged 20 to 40 years old, planned for an elective caesarian delivery and who opted for an IUCD were included. They were randomly divided into two equal groups using lottery method. Women were told about their assigned timing of IUCD placement well before their surgery. Group A had IUCD placed during caesarian section while group B (serving as controls) had insertion after 6 weeks. Cu-T 380 A was provided free of charge to all participants. Women were seen after 6 weeks, 3 months and 6 months. Both groups were analyzed and compared in terms of IUCD expulsion and continued use at 6 months postpartum. Results: The device was placed in 48 women in group A and 35 women in group B (p 0.001). There was no statistically significant difference in device expulsion rates between the two groups (p 0.37). After 6 months significantly higher proportion of women in the intracaesarian group were continuing to use the IUCD as compared to the interval group (p˂0.05) Conclusion: Intra-caesarian placement of IUCD leads to statistically significant higher continuation rates as compared to conventional interval placement with no statistically significant difference in expulsion rates.

scholarly journals INTRAUTERINE CONTRACEPTIVE DEVICE

2018 ◽  
Vol 25 (10) ◽  
pp. 1518-1524
Author(s):  
Faryal Sardar ◽  
Ifat Balouch ◽  
Naseem Bajari
Keyword(s):  
Tertiary Care ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Intrauterine Contraceptive ◽  
Group A ◽  
Group B ◽  
Stratified Analysis ◽  
Effect Of Age ◽  
Trial Setting

Objectives: To compare the frequency of effectiveness of postpartum IUCD(PPIUCD) with interval IUCD at Tertiary care Hospital in Hyderabad. Study Design: Randomizedcontrolled trial. Setting: Gynaecological and Obstetrical Department, Liaquat UniversityHospital, Hyderabad. Period: Six months from February 2016 to July 2016. Material andMethods: Total 100 women were studied. All the women with age 18 to 40 years, having atleast one alive child were included in the study. Women were divided in two groups according tocontraception methods of IUCD (50 women in each group). In Group-A IUCD were inserted afterplacental delivery within 10 minutes to 48 hours (PPIUCD) and in group-B IUCD were insertedany time of women’s menstrual cycle (Interval IUCD). All the women were followed for 6 months.All the data regarding effectiveness among both groups was recorded. Results: Mean ± SDage of group-A (PPIUCD) patients was 26.02 ± 5.87 years while group-B (Interval IUCD) was26.34 ± 5.95 years. Majority of patient’s i-e; 76.0% of group-A and 68.0% of group-B were fromurban areas. IUCD was successfully place among 94.0% women of group-A and among 98.0%women in group-B. At the end of 6 months follow-up, 86.0% patients of group-A continuedPPIUCD while in group-B, 96.0% women continued Interval IUCD. After 6 months follow-up,effectiveness of IUCD was 90.0% in group-B and 80.0% in group-A. Stratified analysis revealedthat there was a non-significant effect of age on effectiveness of IUCD among both groups (Pvalues= 0.094 & 0.223 respectively) so was the parity (P values= 0.384 & 0.747 respectively).Conclusion: It was concluded that interval IUCD found to be effective method as compare topost postpartum IUCD (PPIUCD). While women have recently given birth to neonate were moreagreed to practice of PPIUCD, due to its quick insertion.

scholarly journals A study to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT 380A in Indian women at a premier hospital in New Delhi, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3992 ◽  
Author(s):  
Mansi Kumar ◽  
Mahesh Kumar ◽  
Parul Aggarwal ◽  
Archna Gangania ◽  
Rupali Dewan
Keyword(s):  
Removal Rate ◽  
New Delhi ◽  
Contraceptive Device ◽  
Indian Women ◽  
Significant Difference ◽  
Group A ◽  
Post Placental ◽  
Group B ◽  
Continuation Rates

Background: The Study was planned to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT380A in Indian women at Safdarjung Hospital New Delhi, after approval was obtained from Institutional Ethical committee.Methods: Study group consisted of 300 women, divided into two groups: Group A and Group B. The data was analysed by using ‘student “t” test/ non-parametric ‘Wilcoxon Mann Whitney’ for quantitative variables to evaluate the safety, efficacy and acceptability.Results: Mean age was 24.99 years (range: 19-35years), All women were married (off which 64% literate) and Mean parity in group A was 1.97 and 2.06 in group B. Mean pain score during intrauterine contraceptive device (IUCD) insertion on visual analogue scale was 2.93 in group A and 3 in group B and was not statistically different. 84% women completed 12 months follow up in group A and 83.33% women in group B. Strings were visible in 74% women in group A and in 34% women in group B at 1 month of IUCD insertion. Visibility of strings increased in successive follow up visits and was visible in >80% of women at the end of one year in the both groups. String visibility after intra-Caesarean insertion was delayed. Fifty one percent (n=77) subjects in group A and 54% (n=81) in group B experienced amenorrhea up to six months. Menorrhagia was reported in 7.33% in group A and women 8.66% in group B at the end of 1 year of follow up. Pain was complained by 26 out of 150 (17.3%) women in group A as compared to 36 out of 150 (24%) women in group B after 1 month of insertion. There was no case of PID in group A whereas there were 3 cases of PID in group B. There was no perforation/trauma and pregnancy in either group.Conclusions: Overall expulsion rate was 13% and removal rate was 5% in our study. Continuation rate was 83.3% in Cu 375 and 80.6% in CuT380A at 12 months. There was no significant difference between the IUCDs regarding the safety, efficacy and complications such as expulsion, bleeding etc.

scholarly journals A CLINICAL STUDY OF NEODYMIUM YAG LASER CAPSULOTOMY- THE PATTERN AND ENERGY USED FOR VARIOUS GRADES OF PCO AND OUTCOME

2021 ◽  
Vol 9 (01) ◽  
pp. 34-46
Author(s):  
Karumudi Haneesha ◽  
◽  
T. Sreevatsala ◽  
M. Tejaswi ◽  
◽  
...  
Keyword(s):  
Laser Energy ◽  
Energy Levels ◽  
Visual Outcome ◽  
Maximum Energy ◽  
Subsequent Increase ◽  
Yag Laser ◽  
Circular Pattern ◽  
Initial Setting ◽  
Group A ◽  
Group B

Background :The denser the PCO there is tendency of more energy to be used, Nd: YAG capsulotomy is associated with significant anterior and posterior segment complications. There are no much studies on impact of Nd: YAG laser energy on the rate of complications and opening patterns of capsulotomy on visual function. Objectives: To find out association between the grade and type of PCO with energy used. 2] To compare the visual outcome and complications between circular pattern and cruciate pattern PCO capsulotomy Methodology: The patients are divided into group A and B, group A underwent cruciate and group B underwent circular pattern capsulotomy. A Q- switched Nd: YAG laser Initial setting of 1mJ and subsequent increase of 0.5 mJ as necessary used to make opening in the posterior capsule and the number of pulses used to create capsulotomy and summated total laser energy was noted in each case. Patients were followed for 6 months and analyzed. Results: In this study age of the patients ranged from 6 years to 86 years and the mean age was 62.3+/- 18.2. Maximum energy is required for grade 4 (46.6 mJ) and Least is for grade 1(9.7) More energy is required for fibrous (39.2mJ) and least is for membranous (26.7mJ). In cases who underwent circular pattern. Complications like IOL pitting and uveitis are common in circular pattern compared cruciate pattern, where IOP spikes is a common complication. Conclusion: Grade and Type of PCO significantly influenced laser energy levels required for capsulotomy, whereas Complications are significantly more common when total laser energy was higher. This new technique of cruciate pattern Nd: YAG posterior laser capsulotomy can be performed safely but visual prognosis is better in circular pattern of capsulotomy.

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