Lutz C M, Onwuka A, Lawrence A E, Richards H, Deans K J, McCracken K
Center for Surgical Outcomes, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Center for Surgical Outcomes, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Pediatric Surgery, Department of Surgery and the Research Institute, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
J Pediatr Adolesc Gynecol. 2023 Feb;36(1):79-82. doi: 10.1016/j.jpag.2022.09.003. Epub 2022 Sep 8.
Adolescent females with developmental delays (DDs) experience unique physical and emotional challenges related to menstruation. Providers often recommend hormonal medication for menstrual management. The objective of our study was to describe the utilization and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescents with DDs.
We utilized the Pediatric Health Information System to identify females aged 10-25 with DDs who underwent an LNG-IUS insertion between 2011 and 2020. Using a gynecologic procedure and diagnosis codes, we assessed indications for and complications of LNG-IUS use. We also evaluated early LNG-IUS removal.
One thousand five hundred and sixty female patients with DDs underwent LNG-IUS insertion. LNG-IUS insertion under anesthesia was most commonly performed in patients with autism and Down syndrome, and unspecified menstrual issues were documented for 40% of the cohort. Perforation was observed in 11 patients (1%), and mechanical complications (malpositioned IUS or lost threads) were observed in 23 patients (1%).
This is the largest analysis of LNG-IUS use in patients with DDs to our knowledge and shows the utilization of LNG-IUS in patients with DDs. We provide descriptive information that providers can use to accurately advise their patients with DDs on the risks and benefits of LNG-IUS use for menstrual management.
患有发育迟缓（DD）的青春期女性在月经方面面临着独特的身体和情感挑战。医疗服务提供者通常会推荐使用激素药物来管理月经。我们研究的目的是描述左炔诺孕酮宫内节育系统（LNG-IUS）在患有DD的青少年中的使用情况和安全性。
我们利用儿科健康信息系统，识别出在2011年至2020年间接受LNG-IUS植入的10至25岁患有DD的女性。通过妇科手术和诊断编码，我们评估了LNG-IUS使用的适应症和并发症。我们还评估了LNG-IUS的早期取出情况。
1560名患有DD的女性患者接受了LNG-IUS植入。在患有自闭症和唐氏综合征的患者中，最常进行在麻醉下的LNG-IUS植入，并且该队列中有40%记录有不明月经问题。11名患者（1%）出现穿孔，23名患者（1%）出现机械并发症（宫内节育系统位置不当或尾丝丢失）。
据我们所知，这是对患有DD的患者使用LNG-IUS的最大规模分析，并展示了LNG-IUS在患有DD的患者中的使用情况。我们提供了描述性信息，医疗服务提供者可用于向患有DD的患者准确告知使用LNG-IUS进行月经管理的风险和益处。
