ABSTRACT
Objectives@#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. @*Methods@#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. @*Results@#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. @*Conclusion@#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.
ABSTRACT
Objectives@#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. @*Methods@#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. @*Results@#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. @*Conclusion@#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.
ABSTRACT
Neutropenia occurs often among the newborn of women with pregnancy induced hypertension but its cause and clinical consequences have not been adequately studied. To clarify the previous points 2 groups of neonates have been studied: 26 neonates of mothers with hypertensive gestation and 20 neonates of mothers with uncomplicated pregnancy. Among the neonates of hypertensive gestation, 61.5% had neutropenia, 15.38% aquired nosocomial infection and 11.53% had neutropenia and thrombocytopenia. The granulocyte - macrophage colony forming capacity of the circulating progenitors was studied in vitro in cord blood cultures of all neonates, and in peripheral blood cultures of 10 healthy adults. Sera of cord blood of neonates of hypertensive gestation and sera of their mothers were evaluated to demonstrate the presence of a humoral factor which may affect progenitor cell proliferation. The results obtained revealed a significant increase in the number of colonies yielded from cord blood in both groups of neonates in comparison to peripheral blood cultures. A highly significant decrease in the number of granulocyte - macrophage colony forming units [GM - CFUs], in the neonates of mothers with pregnancy induced hypertension compared to control neonates was found. Marked inhibition in the number of colonies yielded in the three groups studied was noticed in vitro cultures in the presence of sera of pregnancy induced hypertensive mothers and the sera of their neonates. The results reflect the presence of an inhibitor in both maternal and fetal circulation, which needs further studies for its identification. We conclude that neutropenia associated with maternal hypertension is due to reduced circulating progenitors most probably secondary to the presence of an inhibitor in maternal and fetal blood