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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objectives To evaluate role of transvaginal Doppler sonography in cases of irregular uterine bleeding with depot medroxyprogesterone acetate (DMPA). Background Abnormal uterine bleeding is the leading cause of cessation of DMPA use. The definite mechanism of abnormal uterine bleeding has remained vague. Transvaginal Doppler is a noninvasive technique for studying Doppler changes of uterine and spiral artery in cases of abnormal uterine bleeding with DMPA. Patients and methods A case–control study was done on two groups of users of DMPA, one group included 21 cases with abnormal uterine bleeding, and the second group included 21 cases with amenorrhea. Transvaginal sonography was done, and endometrial thickness was measured in greatest sagittal section of the uterus. Uterine and spiral artery pulsatility index (PI) and resistance index (RI) were measured. Data were collected and tabulated. Results Significant changes in PI and RI of uterine and spiral arteries were detected. Uterine artery RI and PI were lower in bleeding group (P = 0.003 and 0.021, respectively), and spiral artery RI and PI were lower in bleeding group (P = 0.0007 and 0.0003, respectively). Conclusion Abnormal uterine bleeding with DMPA is associated with hemodynamic changes in transvaginal Doppler in form of increased blood flow in uterine and spiral arteries as indicated by significant decrease in RI and PI of both arteries.

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