The contradictive findings between ultrasound, hysteroscopy and cytokines in women with nonhormonal IUDs suffering from menorrhagia: a prospective study.

Contraception Embedding Inflammatory Intermenstrual bleeding

Journal

Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213

Informations de publication

Date de publication:
16 Mar 2024
Historique:
received: 24 10 2023
accepted: 05 03 2024
medline: 16 3 2024
pubmed: 16 3 2024
entrez: 16 3 2024
Statut: aheadofprint

Résumé

The objective of this study is to assess the correlation between bleeding irregularities and the accurate placement of the intrauterine device (IUD) device in the uterine cavity, determined through transvaginal ultrasonography and hysteroscopy. In addition, the study aims to examine the cytokine profile in the uterine cavity and serum of patients experiencing bleeding irregularities after the insertion of nonhormonal IUDs. A prospective cohort study was conducted at a single tertiary medical center, wherein patients experiencing intermenstrual bleeding and spotting after the insertion of nonhormonal IUDs were enrolled. The study involved hysteroscopic and sonographic assessments of the uterine cavity and IUD placement, along with the analysis of blood and uterine cavity cytokine profiles. During the period between July 2019 and February 2020, a total of eight patients who experienced intermenstrual bleeding and spotting after the insertion of nonhormonal IUDs were enrolled the study. One case was excluded since a progestative device was detected by ultrasound. Out of the five cases that underwent a thorough ultrasonographic assessment, three cases (60%) showed an embedded IUD. However, these findings were excluded by the hysteroscopic evaluation. The results suggest that ultrasonographic assessment may lead to an overdiagnosis of IUD mispositioning compared to hysteroscopy. In addition, both ultrasound and hysteroscopy have limitations in diagnosing the cause of bleeding in most cases. The role of local reactive inflammatory cytokines should be further studied.

Identifiants

pubmed: 38492083
doi: 10.1007/s00404-024-07457-7
pii: 10.1007/s00404-024-07457-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Hadel Watad (H)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. Hadeel.wattad@mail.huji.ac.il.
School of Medicine, Tel Aviv University, Tel Aviv, Israel. Hadeel.wattad@mail.huji.ac.il.

Udi Ifrach (U)

Bar-Ilan University, Ramat Gan, Israel.

David Stockheim (D)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Vered Yulzari (V)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Orly C Meron (OC)

The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel.

Miri Blank (M)

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Benjamin Sredni (B)

C.A.I.R. Institute, The Safdié AIDS and Immunology Research Center, The Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel.

Boaz Weisz (B)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Shlomo B Cohen (SB)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Classifications MeSH