Assessment of the efficacy of uterine artery Doppler in predicting the response to Mefenamic Acid during treatment of women having IUCD associated menorrhagia

Abstract

Background: Bleeding with IUCDs is considered iatrogenic dysfunctional uterine bleeding. The bleeding associated with IUCD use may either occur during menstruation (heavy and/or prolonged) or in the form of intermenstrual bleeding and spotting.Patients and Methods:This study was carried out on 156 women attended the family planning out-patient clinic in the Obstetrics and Gynecology Department, Ain-Shams University Hospitals, during the period from May 2017 to May 2018. Patients were divided according to the response to treatment into two groups: Group (I): Responders to treatment with Mefenamic acid and Group (II): Non-responders to treatment with Mefenamic acid. Response to treatment was evaluated according to: Pictorial blood loss assessment chart.Results: Interpretation of the results of this work showed that uterine artery mean value of the PI of the women who responded to treatment with Mefenamic acid (group I) (1.54±0.42) were significantly higher than mean value of PI of women who didn’t respond to treatment with Mefenamic acid (group II) (0.96±0.28), also showed that uterine artery mean value of the RI of the who responded to treatment with Mefenamic acid (group I) (1.01±0.25) were significantly higher than mean values of RI of women who didn’t respond to treatment with Mefenamic acid (group II) (0.71±0.21). Doppler indices showed that pulsatility index ≥ 1.27 had moderate sensitivity (75.3%) and NPV (75.3%) but high specificity (90.1%) and PPV (90.1%) in prediction of responders. Resistive index ≥ 0.93 had low sensitivity (69.4%) and NPV (70.8%) but moderate specificity (88.7%) and PPV (88.1%) in prediction of responders.Conclusion:There is a strong relationship between uterine artery Doppler indices and prediction of response to Mefenamic acid.