Study Objective

To evaluate the use of intrauterine devices (IUDs) in two young women's hematology clinics and compare adverse events in adolescents with and without inherited bleeding disorders (BDs)

Design

Retrospective multicenter cohort study from February 2014 through February 2020

Setting

Young women's hematology clinics at Nationwide Children's Hospital in Columbus, Ohio, and Children's Medical Center in Dallas, Texas

Participants

Female patients evaluated for heavy menstrual bleeding (HMB) who underwent IUD placement

Interventions and Main Outcome Measures

Rates of IUD expulsion, malposition, and ongoing HMB requiring additional medical treatment

Results

We identified 43 patients with BDs and 35 patients without BDs who underwent placement of an IUD for HMB. The mean age was 14.9 years (range 11.0-21.4 years) at the time of presentation and 15.8 years (range 11.0-21.4 years) at IUD placement. Those with BDs were younger at the time of IUD insertion. Most patients (90%) had previously failed other methods to control HMB. The annual rate of IUD adverse events was 0.25 per year of use, and all adverse events occurred in the first 20 months after placement. There were no significant differences in adverse IUD events in patients with and without BDs, although those without BDs requested IUD removal more frequently.

Conclusions

In this cohort of adolescent females, the presence of a BD was not associated with a higher IUD expulsion rate. IUD placement should be considered a first-line option for adolescents with BDs who experience HMB.

中文翻译：

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月经大量出血的年轻女性使用宫内节育器的结果：有无遗传性出血性疾病患者的比较

学习目标

评估两个年轻女性血液科诊所使用宫内节育器 (IUD) 的情况，并比较患有和不患有遗传性出血性疾病 (BD) 的青少年的不良事件

设计

2014 年 2 月至 2020 年 2 月的回顾性多中心队列研究

环境

俄亥俄州哥伦布市全国儿童医院和德克萨斯州达拉斯儿童医疗中心的年轻女性血液学诊所

参加者

接受宫内节育器放置的女性患者经评估有严重月经出血 (HMB)

干预措施和主要成果措施

宫内节育器取出率、位置不当和需要额外治疗的持续 HMB 率

结果

我们确定了 43 名患有 BD 的患者和 35 名没有 BD 的患者，他们接受了 HMB 的宫内节育器放置。就诊时的平均年龄为 14.9 岁（范围 11.0-21.4 岁），放置 IUD 时的平均年龄为 15.8 岁（范围 11.0-21.4 岁）。那些有 BD 的人在放置宫内节育器时更年轻。大多数患者 (90%) 以前用其他方法控制 HMB 均失败。宫内节育器不良事件的年发生率为每年使用 0.25 次，所有不良事件均发生在放置后的前 20 个月内。有和没有 BD 的患者的 IUD 不良事件没有显着差异，尽管没有 BD 的患者要求取出 IUD 的频率更高。

结论

在这个青春期女性队列中，BD 的存在与较高的宫内节育器排出率无关。宫内节育器放置应被视为患有 HMB 的 BD 青少年的一线选择。