Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device

被引:167
作者
Fedele, L
Bianchi, S
Raffaelli, R
Portuese, A
Dorta, M
机构
[1] UNIV MILAN,DEPT OBSTET & GYNECOL,MILAN,ITALY
[2] OSPED GALLARATE,GALLARATE,ITALY
[3] UNIV VERONA,DEPT RADIOL,I-37100 VERONA,ITALY
[4] UNIV VERONA,POLICLIN BORGO ROMA,DEPT OBSTET & GYNECOL,I-37134 VERONA,ITALY
关键词
adenomyosis; menorrhagia; levonorgestral-releasing intrauterine device;
D O I
10.1016/S0015-0282(97)00245-8
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To evaluate the efficacy and tolerability of treatment with a levonorgestrel-releasing intrauterine device (IUD) in women affected by adenomyosis-associated menorrhagia. Setting: Tertiary care center. Design: Prospective, open, noncomparative study. Patient(s): Twenty-five women aged 38 to 45 years with recurrent menorrhagia associated with adenomyosis diagnosed at transvaginal ultrasonography participated in this study. Intervention(s): An IUD releasing levonorgestel 20 mcg/day was inserted in each patient within 7 days of the start of menstrual flow. All of the patients were requested to compile a pictorial blood loss assessment chart each month. They underwent clinical and transvaginal ultrasound examinations 3, 6, and 12 months after IUD insertion. Main Outcome Measure(s): Menstrual pattern; serum hemoglobin, ferritin, and iron level changes. Result(s): One patient experienced IUD expulsion 2 months after device insertion and another requested removal of the IUD 4 months after insertion because of persistent irregular blood loss. Six months after IUD insertion, amenorrhea was observed in 2 patients and oligomenorrhea in another, spotting occurred occasionally in 7, and 13 had scanty but regular flow. One year of follow-up has been completed by the remaining 28 women: 2 with amenorrhea, 3 with oligomenorrhea, 2 with spotting, and 16 with regular flows. Significant increases in hemoglobin, hematocrit, and serum ferritin have been observed, but the lipid metabolism and clotting variables have remained unchanged. Conclusion(s): Our findings indicate that marked and safe relief from adenomyosis-associated menorrhagia can be obtained with the use of a levonorgestrel-releasing IUD. (C) 1997 by American Society for Reproductive Medicine.
引用
收藏
页码:426 / 429
页数:4
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