Provider Attitudes and Practices Regarding Intrauterine System (IUS) Insertion in Adolescents With and Without Bleeding Disorders for Management of Heavy Menstrual Bleeding - 08/07/21
, Allison P. Wheeler 2, Claudia Borzutzky 3, Kristina M. Haley 4, Peter Kouides 5, Oluyemisi Adeyemi-Fowode 6ABSTRACT |
Study Objective |
Heavy menstrual bleeding (HMB) may be the sentinel event for identifying a patient with a bleeding disorder (BD). The levonorgestrel intrauterine system (LNG IUS) has been proposed as a treatment for HMB in adolescents with and without BDs; however, no standard protocols for LNG IUS insertion in these populations exist. Providers were surveyed regarding the use of the LNG IUS in adolescents with HMB, with and without BD.
Design, Setting, Participants, Interventions, and Main Outcome Measures |
An institutional review board−approved survey assessing provider attitudes, LNG IUS insertion practices, and patient outcomes in adolescents with HMB, with and without BD, was electronically distributed to 3523 providers in the fields of hematology, adolescent medicine, and obstetrics and gynecology. Descriptive analysis was performed.
Results |
A total of 312 respondents across all 3 specialties completed the survey. Nearly 100% of respondents considered the LNG IUS safe and effective treatment for adolescents with HMB, both with and without BD. Additionally, 66% of providers chose LNG IUS as the ideal treatment for HMB in patients with BD. Differences were noted in clinical setting for LNG IUS insertion, peri-procedural medication use, and post-procedure follow-up among specialties. Providers across all specialties reported low complication rates related to IUS insertion and use in both patient groups.
Conclusion |
Providers considered the LNG IUS safe and effective treatment for HMB in adolescents with and without a diagnosed BD. Practice patterns regarding LNG IUS insertion in this population vary. Further research is necessary to explore IUS outcomes in adolescent patients with HMB, with and without BD, and to inform evidence-based protocols for LNG IUS insertion.
Il testo completo di questo articolo è disponibile in PDF.Key Words : Heavy menstrual bleeding, Female adolescents, Progesterone-releasing intrauterine devices, Hemostatic disorders
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| None of the authors have any potential conflicts of interest to disclose. |
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| Non-financial support was provided by the Foundation for Women and Girls with Blood Disorders (FWGBD). No sources of funding to disclose. |
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| This work was published as a virtual poster presentation at the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Annual Meeting, Grapevine, TX, on April 1, 2020 (virtual poster presentation secondary to COVID-19 cancellation of in-person meeting). |
Vol 34 - N° 4
P. 514-521 - agosto 2021 Ritorno al numero
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