scholarly journals Investigation of abnormal uterine bleeding in perimenopausal women by hysteroscopy and endometrial biopsy

2005 ◽  
Vol 2 (1) ◽  
pp. 51-55 ◽  
Author(s):  
I. Stamatellos ◽  
P. Stamatopoulos ◽  
D. Rousso ◽  
E. Asimakopoulos ◽  
C. Stamatopoulos ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Perimenopausal Women

scholarly journals Evaluation of endometrial thickness with transvaginal ultrasonography in perimenopausal women presenting with abnormal uterine bleeding and correlation with its histopathological findings

2019 ◽  
Vol 8 (11) ◽  
pp. 4496
Author(s):  
Noor Ayesha Begum ◽  
Lokesh Chandra H. C. ◽  
Ravindra S. Pukale
Keyword(s):  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Transvaginal Ultrasonography ◽  
Common Finding ◽  
Histopathological Findings ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Most frequently used diagnostics tests to investigate the causes of abnormal bleeding are Transvaginal ultrasonography (TVS) and endometrial biopsy. Uterine curettage is an invasive procedure and is performed with anaesthesia. TVS is a non-invasive method that has been used to evaluate the endometrium and uterine cavity. The objectives of this study were to measure and evaluate the role and accuracy of endometrial thickness by transvaginal ultrasonography study to detect endometrial pathology in perimenopausal women presenting with Abnormal Uterine Bleeding. To correlate the transvaginal sonographic results with the Histopathological findings to discriminate normal from pathological endometrium.Methods: Prospective study including 150 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TVS and then D and C was performed for all the patients.Results: Out of 150 women, 128 (85.3%) had normal and 22 (15%) had an abnormal endometrium. 43.3% were of 41-45 years and 65.3% patients presented with complaint of heavy menstrual bleeding. Majority of the patients in the study group were para 2 or more. Fibroid uterus (24%) was the commonest uterine pathology detected on TVS. 53.3% of patients had endometrial thickness in the range 10-14.9 mm. Most common finding on HPE was secretory endometrium (44.6%). Endometrial carcinoma was found in 3%. Endometrial thickness <14mm was associated with least abnormal endometrial pathology.Conclusions: Endometrial thickness of less than 14 mm need not be indicated for D and C in perimenopausal abnormal uterine bleeding. In perimenopausal women with AUB, TVS should be the investigation of choice due to its convenience, accuracy and non- invasiveness.

A COMPARATIVE STUDY OF PREOPERATIVE ENDOMETRIAL BIOPSY AND ENDOMETRIAL CURETTAGE FROM HYSTERECTOMY SPECIMEN IN PERIMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
pp. 29-32
Author(s):  
Zothansung Joute ◽  
Telen Thangkhojam Kom ◽  
Phirthangmoi Fimate ◽  
Rajesh Singh Laishram
Keyword(s):  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Positive Predicted Value ◽  
Perimenopausal Women ◽  
Important Diagnostic Tool ◽  
Proliferative Endometrium

Objective: To assess the diagnostic accuracy of preoperative curettage biopsy samples and to correlate the ndings with post hysterectomy curettage samples for different endometrial pathologies. Methods: This cross-sectional study was conducted from October 2012 to September 2014 in the Department of Pathology in collaboration with the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur. Approval from institutional ethical committee was taken before starting the study. Specimens of all perimenopausal women with abnormal uterine bleeding (AUB) who underwent endometrial biopsy and subsequent hysterectomy were studied in the Department of Pathology. Results: A total of 50 cases of clinically diagnosed patients with abnormal uterine bleeding were studied. Preoperative Endometrial curettage biopsy was followed By curettage post-hysterectomy. Biopsy ndings were correlated with post-hysterectomy curettage ndings. The age group of the patients range from 37 years to 53 years with maximum number of cases in the range of 45 to 50 years (38%). Proliferative endometrium was the most common pattern (56%) obtained by endometrial curettage biopsy as well as in post hysterectomy curettage followed by secretory endometrium. Statistical analysis of endometrial biopsy study of 48 cases showed that it has a high Sensitivity (100%), Negative predicted value (100%), Specicity (97.44%) and Positive predicted value (90.91%). The Accuracy of the test was 98%. Conclusions: While endometrial curettage biopsy using uterine curette is not the gold standard for diagnosing endometrial pathologies in AUB, it is an important diagnostic tool in the investigation for assessment of endometrium as it has few advantages.

scholarly journals ENDOMETRIAL STUDY OF ABNORMAL UTERINE BLEEDING IN WOMEN AT 45 YEARS AND ABOVE

2003 ◽  
Vol 42 (146) ◽  
pp. 83-85
Author(s):  
Ganesh Dangal
Keyword(s):  
Vaginal Bleeding ◽  
Elderly Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Abnormal Bleeding ◽  
Post Menopausal ◽  
Abnormal Vaginal Bleeding

ABSTRACTThe study is done to know the causes for the abnormal uterine bleeding in perimenopausal women atChitwan valley and to compare the histopathological findings between the pre-menopausal andpostmenopausal women. Retrospective analysis of patients who have had abnormal bleeding during a periodof one and a half years' from January 2000 to June 2001 in Department of Gynaecological Oncology of BPKoirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. There were total sixty women (aged 45years and above) having abnormal bleeding managed at BPKMCH. A total of sixty patients were studied.Majority (57%) of them was postmenopausal ladies presented with abnormal vaginal bleeding. The agerange was 45 to 81 years. Only 37% had pathological bleeding including malignancies and only about 17%had malignancies. Malignant diseases were found in 7.7% cases in the pre-menopausal ladies whereas itwas 23.4%, almost three times higher, in the post-menopausal ladies. Carcinoma of the cervix and of theendometrium occurred with increasing frequency with increasing age in this study. So, a thorough work-upis needed for the elderly women presenting with an abnormal vaginal bleeding especially to rule outmalignancies.Key Words: endometrial biopsy, endometrial cancer, postmenopausal bleeding.

scholarly journals Histopathological pattern of endometrial samples in abnormal uterine bleeding

1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Physiological Changes ◽  
Biopsy Material ◽  
Histological Pattern ◽  
Biopsy Specimens ◽  
Histological Characteristics

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

2017 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Histopathological Findings ◽  
Number Of Patients ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals Histo-Pathological Study of Endometrial Biopsies in Patients With Abnormal Uterine Bleeding

2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
The Elderly ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Cause ◽  
Histopathological Findings ◽  
Common Sign ◽  
Work Up

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 

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