CAN HYSTERECTOMY BE PREVENTED: TO EVALUATE THE EFFECTIVENESS OF LEVONORGESTREL-INTRAUTERINE SYSTEM(MIRENA) IN WOMEN WITH ABNORMAL UTERINE BLEEDING AND ITS CLINICOPATHOLOGICAL CORRELATION

AIM:To study the efcacy and acceptance rate of conservative approach of abnormal uterine bleeding through Levonorgestrel releasing Intrauterine device-MIRENAin Indian setup. MATERIALAND METHODS:The study was conducted on 50 women of age group 28-50 years after ruling out all exclusion criteria.These women were followed up till 1 year to assess the efcacy of Mirena in controlling the abnormal uterine bleeding as well rate of acceptance. RESULT:In this study 50 women with complaint of abnormal uterine bleeding were managed conservatively by inserting MIRENA in utero.Out of 50 women 26(52%) had associated comorbidities.Menstrual pattern changed from heavy menstrual bleeding to amenorrhoea in 15(30%),spotting in 20(40%) and normal menstrual cycle in 10(20%) while didn't improve in 5(10%) cases.Dysmenorrhoea improved in 42(84%) cases.Very few patients experienced complications like vaginal discharge in 7(14%)cases and weight gain in 5(10%) cases.Only 5(10%) cases had no improvement in heavy menstrual bleeding and were additionally given adjuvant drug therapy to control bleeding.Subsequently in these patients Mirena was removed and hysterectomy was done.3 patients were apprehensive about the amenorrhoea attained and among them 1 ended up in removing the device.Overall satisfaction and acceptance rate is 42(84%). CONCLUSION:Mirena is one of the newer modalities in developing country like India for conservative management of abnormal uterine bleeding.Not only it curtails the need of surgical intervention moreover it improves the quality of life of women and decreases the rate of morbidity and mortality in women with co-existing medical illness. CLINICAL SIGNIFICANCE:In developing countries since the population is increasing exponentially the rate of hysterectomies to alleviate the symptoms of abnormal uterine bleeding is also increasing.This better conservative approach through Mirena will help to decrease the burden of surgical procedures as well prove to be a blessing to women to improve quality of life.