{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:10:20Z","timestamp":1767136220988,"version":"build-2238731810"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology & Obste"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n \n To compare the effects of a levonorgestrel\u2010releasing intrauterine system (\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n ) and a copper intrauterine device (Cu\u2010\n IUD<\/jats:styled-content>\n ) on menstrual changes and uterine artery Doppler indices.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A randomized clinical trial was conducted at Menoufia University Hospital, Egypt, between December 2016 and August 2017. 306 multiparous women desiring intrauterine contraception were randomly assigned to\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n (n=152) or Cu\u2010\n IUD<\/jats:styled-content>\n (n=154). Uterine artery pulsatility index (\n PI<\/jats:styled-content>\n ) and resistant index (\n RI<\/jats:styled-content>\n ) were measured before use, and 3 and 6\u00a0months after insertion, and associations with abnormal bleeding were evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Irregular bleeding was initially reported by 31 (74%) of 42 women in the\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n group, and heavy menstrual bleeding by 53 (67%) of 79 women in the Cu\u2010\n IUD<\/jats:styled-content>\n group. Incidence of abnormal bleeding decreased over the 6\u2010month study period. Uterine artery\n PI<\/jats:styled-content>\n was significantly correlated with abnormal bleeding at a cutoff of 1.35 with area under the curve (\n AUC<\/jats:styled-content>\n ) 0.93, sensitivity 88%, and specificity 100%, whereas uterine artery\n RI<\/jats:styled-content>\n was significantly correlated with abnormal bleeding at a cutoff of 0.62 with\n AUC<\/jats:styled-content>\n 0.1, sensitivity 96%, and specificity 100%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n \u2010related abnormal bleeding was associated with changes in uterine artery blood flow that were not evident among Cu\u2010\n IUD<\/jats:styled-content>\n users.\n <\/jats:p>\n \n Pan African Clinical Trials Registry:<\/jats:bold>\n PACTR<\/jats:styled-content>\n 201701001900640.\n <\/jats:p>\n 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