Can the response to three months Ibuprofen for controlling Heavy Menstrual Bleeding with IUD be predicted at baseline visit?

• Main Authors: Mohammed k Ali (Author), Ahmed M Abbas (Author), Ali H Yosef (Author), Osama S Abdalmageed (Author), Mustafa Bahloul (Author)
• Format: Book
• Published: Journal of Gynecological Research and Obstetrics - Peertechz Publications, 2017-11-21.
• Subjects: Research Article
• Online Access: Connect to this object online.

Summary

<p><strong>Objective:</strong> The present study examines the hypothesis that the clinical and ultrasonography data reported at baseline visit can predict the responsiveness of ibuprofen in controlling heavy menstrual bleeding with Cu-IUDs at 3 months follow-up visit. <br></p><p><strong>Materials and methods: </strong>We used data revealed from a single center open label prospective cohort study conducted at Woman's Health Hospital, Assiut University, Egypt in the period between the 1st of October 2015 and the 30th of September 2016. This study included 128 women complaining of heavy/ prolonged menstrual bleeding with Cu-IUD; they received ibuprofen for three consecutive cycles. Seventy patients (54.68%) respond to ibuprofen and while 58 patients (45.31%) did not respond. Logistic regression was done to show the signifi cant predictors of ibuprofen response and a receiver operating characteristic (ROC) curves was used to evaluate the sensitivity and specifi city of the potential predictors revealed by logistic regression. <br></p><p><strong>Results: </strong>The responders had fewer number of bleeding days per month (5.1 ± 1.7 vs. 7.41 ± 1.7 days in the non-responders, p<0.001). Additionally, the uterine volume was signifi cantly smaller in the responders than the non-responders with statistically signifi cant difference (47.01 ± 6.5 mL vs. 60.9 ± 25.5 mL, p=0.001; respectively). Women reporting higher number of bleeding days per month (OR 3.26, 95% CI 1.06-10.03, p<0.001), larger uterine volume (OR 1.26, 95% CI 1.00-1.59, p=0.03) and lower uterine PI (OR 0.15, 95% CI 0.23-0.95, p=0.005 were likely to not succeed to be controlled by ibuprofen. Our predictive model can predict the failure of ibuprofen when utilize the 3 prior predictors with 93.5% sensitivity, 57.5%specifi city, 67.4% PPV, 90.5% NPV and 75.0%accuracy. <br></p><p><strong>Conclusion: </strong>Women reporting a lot of bleeding days per month, high uterine volume and low uterine artery PI during baseline visit may not respond to ibuprofen in controlling of heavy menstrual bleeding with Cu-IUD.</p>

DOI

10.17352/jgro.000046