scholarly journals OP18.01: Prognostic role of findings at sonohysterography in post-menopausal patients with abnormal uterine bleeding and abnormal uterine transvaginal sonography

2006 ◽  
Vol 28 (4) ◽  
pp. 499-499
Author(s):  
F. P. G. Leone ◽  
C. Lanzani ◽  
T. Bignardi ◽  
C. Marciante ◽  
E. Ferrazzi
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.


Author(s):  
Neerja Gupta ◽  
Geeta Singh ◽  
Bharti Jain ◽  
Satakshi Garg

Background: Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynaecological advice. The objective of this study was to determine the accuracy of Transvaginal sonography (TVS) and Saline Infusion Sonography (SIS) in evaluation of Abnormal Uterine Bleeding (AUB) and to compare the diagnostic accuracy after hysterectomy.Methods: Prospective, comparative study of TVS and SIS in evaluation of AUB in patients who are being subjected to hysterectomy with uterus of less than 12 weeks.Results: 100 patients were included in the study. 98% were of 30-50 years. Heavy menstrual bleeding was the commonest symptom (52%) and most common finding was fibroid, and Polyp followed by abnormal endometrium. The overall sensitivity and specificity when correlated with operative and HPE were 66% and 88% respectively for TVS and 82% and 95% for SIS respectively. The false positive and false negative rates were more in TVS compared to SIS. Commonest histopathology was intramural fibroid in 42% followed by sub mucus myoma in 21%, polyp 18% and endometrial hyperplasia 10%.Conclusions: SIS is a simple highly sensitive and specific technique to detect intra uterine pathology in the evaluation of AUB when TVS findings are inconclusive.


Author(s):  
Atul Padmawar ◽  
Ankita Khande

Background: Abnormal uterine bleeding is defined as any type of bleeding in which the duration, frequency or amount is excessive for an individual patient. Hysteroscopy has ushered a new era in the evaluation of abnormal uterine bleeding. With this background, we conducted a study to find the role of hysteroscopy with dilation and curettage in post-menopausal bleeding.Methods: It was an observational study conducted in the department of obstetrics and gynecology of a tertiary care hospital in Maharashtra. Post-menopausal patients with abnormal uterine bleeding, admitted in the period of March 2018 to September 2019 were included in the study. A pretested and predesigned questionnaire was used to collect the data. Hysteroscopy with dilation and curettage was done and samples were sent for histopathology.Results: Bleeding was present in all the 30 cases. About 33.33% had pain abdomen, 56.67% had hot flushes, 10.00% had mass and 10% had other symptoms in the present study. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of hysteroscopy in diagnosing malignancy was 75%, 96.15%, 75%, 96.15% and 93.33% respectively.Conclusions: To conclude the most common cause of abnormal uterine bleeding in post-menopausal women in our study was polyp. The sensitivity and specificity of the hysteroscopy in diagnosing the malignant lesions is 75% and 96.15% respectively which corroborated with other study findings. Hysteroscopy with dilation and curettage is better alternative to hysterectomy and biopsy in most of the cases. 


Author(s):  
Markad Swapnil Balaram ◽  
Roopa R. Shinde ◽  
C. Suresh Babu ◽  
Hamid Mubashar Mohamed Mubasher ◽  
Ranoji Vijaysing Shinde

Background: Menstrual irregularities and abnormal heavy menstruation account for up to 26-35% of women attending Gynecological outpatient Department. Abnormal Uterine Bleeding (AUB), it is more common at extremes of age endometrial hyperplasia occurs in 5-10% of patients with post-menopausal bleeding out of which atypical hyperplasia has 26-32 % risk of having malignancy in future. Therefore, endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding is mandatory. Our study was conductive to know the effectiveness of pipelle type devices, versus Dilatation and curettage in obtaining quality endometrial tissue for histopathological examination.Methods: The study was undertaken in Department of obstetrics and gynaecology along with department of Pathology at Rajarshi Chhatrapati Shahu Maharaj, government medical college, Kolhapur after getting approval from the Hospital Committee on Clinical Research and Ethical Committee of the institution, during the period from October 2016 to March 2017 (six months). Total number of subjects included in study is Hundred after taking into consideration of inclusion and exclusion criteria.Results: The ease of doing procedure was much easier as compared to D&C and the Tissue sample obtained for histopathological examination were as par D&C. It was concluded that histopathology report was available in 92 of the 100 pipelle samples and 93 of 100 D&C samples. It was also, observed that increased endometrial thickness was not always associated with adequate tissue diagnosis.Conclusions: Pipelle is simple, affordable, patient friendly can be easily performed with minimal training, which can be performed in Outpatient Gynaecological Department. The diagnostic value and positive predictive value of Pipelle is at par with conventional D&C. So, pipelle can be recommended for all perimenopausal patients with AUB to rule out various, premalignant and malignant conditions of the endometrium.


2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Nazlima Nargis ◽  
Iqbal Karim ◽  
Khondaker Bulbul Sarwar

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139


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