Revista Sextante

Assessing the Morphology of Uterus After Using Intrauterine Contraceptive Device on Ultrasonography

Sania Zahoor

Department of Radiology, TIMES University, Multan, Pakistan

Munawar Abbas

Department of Radiology, TIMES University, Multan, Pakistan

Keywords: Intrauterine contraceptive device, uterine morphology, ultrasonography, device malposition, endometrial thickness, heavy menstrual bleeding

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Abstract

Although ultrasonography technology can be used to clarify the morphology of the uterus and position of intrauterine contraceptive device (IUCD), the relationship between both with symptoms should be elucidated. This study evaluated the sonographic findings, endometrial thickness and clinical associations in IUCD users. Total of 263 women were studied in THQ hospital, Layyah as a cross-sectional study. Evaluation of participant characteristics, position of the device in the uterus/pelvis, uterine findings, pelvic findings and menstrual symptoms. Group comparisons, Spearman correlations and multivariable logistic regression were reported. Mean age was 29.60 ± 5.97 years, and 88.6% used copper T devices. The devices were typically in 204 women (77.6%) and malpositioned in 59 (22.4%), with 36 being displaced, 16 embedded, and seven being expelled. No perforations reported. 26.0% (25 out of 96 women) had niches in their caesarean scars. In women with heavy menstrual bleeding, the endometrial thickness was higher in the copper T IUCD group compared to the hormonal IUCD group (6.50 versus 5.01 mm; p < 0.001); and greater in the copper T group compared to the non-IUCD group (6.50 versus 4.93 mm; p < 0.001). A correlation was observed between thickness and bleeding after insertion (ρ = 0.53; p < 0.001). Prolonged pain following insertion (OR = 4.57) and lower abdominal pain (OR = 3.09), but not heavy bleeding, was associated with malposition. The exploratory adjusted association with malposition was identified in the abortion history but was poor. There was no significant relationship between device position within the uterus or for the duration of use with endometrial thickness in the set of reported group comparisons.