Pain and bleeding pattern related to levonorgestrel intrauterine system (LNG-IUS) insertion
| Autor: | Dirk Timmerman, Thierry Van den Bosch, Dominique Van Schoubroeck, E. Werbrouck, Lieveke Ameye, An Hindryckx, Joan Veldman |
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| Rok vydání: | 2013 |
| Předmět: |
endocrine system
medicine.medical_specialty Population Uterus Pain Levonorgestrel Pregnancy medicine Contraceptive Agents Female Humans Prospective Studies education Prospective cohort study Amenorrhea Ultrasonography education.field_of_study business.industry Intrauterine Devices Medicated Obstetrics and Gynecology Surgery Parity medicine.anatomical_structure Reproductive Medicine Coronal plane Female medicine.symptom business Postpartum period Cohort study medicine.drug |
| Zdroj: | European journal of obstetrics, gynecology, and reproductive biology. 171(1) |
| ISSN: | 1872-7654 |
| Popis: | Objective To investigate whether the pattern or pain or bleeding during levonorgestrel intrauterine system (LNG-IUS) insertion and in the first 6 weeks thereafter is altered by LNG-IUS malposition. Study design Prospective cohort of 413 women undergoing LNG-IUS insertion or replacement. A first questionnaire on pain perception was completed by the women immediately after insertion. In a second questionnaire the women were asked to record pain in the 3 days following insertion and both pain and bleeding from 4 to 6 weeks after insertion. Six weeks after insertion a 2D- and 3D-ultrasound examination was performed to evaluate the position of the LNG-IUS and of the uterus. Results Parity was inversely related to pain at insertion, in the first 3 days and at 4–6 weeks. LNG-IUS insertion was less painful in the postpartum period. Women who had had a LNG-IUS as prior contraceptive method reported a higher percentage of amenorrhea at 4–6 weeks. The position of the LNG-IUS or of the uterus did not influence the pain scores or the bleeding pattern. The fact that the LNG-IUS arms appeared embedded in the uterine wall on coronal 3D-volume reconstruction did not influence pain or the bleeding pattern. Conclusions Because neither pain nor bleeding is a reliable predictor of LNG-IUS position, we suggest an ultrasound examination to confirm correct LNG-IUS placement in all patients at about 6 weeks after insertion. |
| Databáze: | OpenAIRE |
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