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ISSN-0303-5212 |
| The
Journal of the Pakistan Medical Association Rawalpindi - Islamabad |
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Volume 34, Number 2, July - Dec. 2009 |  |
| Original article |
| Effectiveness and safety of Levonorgestrel releasing intrauterine system in treatment of menorrhagia secondary to oral anticoagulations and chronic liver disease |
| Abeera Choudry, Ayesha Malik, Humaira Choudry, Naila Bangish, Naheed Hayat |
| Objective To determine whether the levonorgesterol releasing intra-uterine contraceptive device can safely reduce menstrual blood loss and improve quality of life in patients with bleeding disorders and those on oral anticoagulation. Method Sixty nine age matched controls and 133 consecutive patients of ACS were studied. CRP levels, CK-MB and Trop-I were measured at 0, 12 and 24 hours of admission. Ejection fraction was estimated by bidimensional echocardiography. Results Eighteen patients with bleeding disorders (3 chronic liver disease and 6 on anticoagulation with warfarin) were included in the study. One patient was lost to follow up after 3 months. Remaining were followed for one year. Continuity rate was 91% at one year. Mirena resulted in decrease in menstrual blood loss by 60% at 3 months, 70% at 6 months and 85 % at one year (p<0.001 for all). Seven (31%) became amenorrhic and another seven (31%) had intermenstrual spotting. Blood transfusion requirement was completely eliminated. Patient satisfaction was very high. Conclusions In patients with bleeding and coagulation disorders, Levonorgesterol releasingintrauterine system provided an efficacious and satisfactory choice in the treatment of menorrhagia and it reduced the need for blood transfusion and surgery. (Rawal Med J 2009;34:187-190) |
| Key Words: LNG-IUS, menorrahagia, bleeding disorders, CLD. |
| Abbreviations: MBL: Menstrual blood loss, Hb: Haemoglobin, LNG-IUS: Levonorgesterol releasing-intrauterine system, PBAC: Pictorial blood assessment chart, CLD: chronic liver disease. |
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