scholarly journals Endometrial Cut Off Thickness as Predictor of Endometrial Pathology in Perimenopausal Women with Abnormal Uterine Bleeding: A Cross-Sectional Study

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Prity Kumari ◽  
Harsha S. Gaikwad ◽  
Banashree Nath
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Endometrial Sampling ◽  
Group I ◽  
Significant Difference ◽  
Perimenopausal Women ◽  
Endometrial Pathology

Purpose. We aim to determine the predictive value of endometrial thickness by transvaginal ultrasonography (TVS) in diagnosing endometrial pathology and to evaluate whether Doppler complements its diagnostic efficacy in perimenopausal women with abnormal uterine bleeding. Methods. This cross-sectional observational study was conducted among 70 perimenopausal women with AUB who underwent TVS measurement of endometrial thickness (ET) and Doppler flow indices followed by endometrial sampling and histopathological examination (HPE). Results. In HPE, 51 (73%) women had normal diagnosis while 19 (27%) women had neoplastic histology either benign or malignant. They were categorised into group I and group II, respectively. There was a significant difference in age ( P = 0.001 ) and incidence of obesity ( P = 0.01 ) between the two groups. The ETs measured in group I and group II were 7.89 ± 2.62 mm and 14.07 ± 3.96 mm, respectively, with significant difference ( P < 0.001 ). A TVS-ET of 10.5 mm had the highest sensitivity and specificity of 89.5% and 86.3%, respectively, PPV of 70.68%, NPV of 95.68%, LR+ of 6.52, and LR− of 0.12. Doppler flow velocimetric study of endometrial and uterine vessels did not demonstrate a significant difference. Conclusions. Women in perimenopause with AUB should be offered to undergo endometrial sampling for histopathological examination if TVS ET ≥10.5 mm. The coexisting risk factors especially higher age (>45 years) and obesity (BMI>30) significantly escalate the chances of developing endometrial pathology.

scholarly journals A prospective study on the efficacy of Pipelle biopsy to diagnose endometrial pathology in patients with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4238
Author(s):  
Sunitha Mary Mathew ◽  
Pramod Thomas
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Focal Lesions ◽  
Endometrial Sampling ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.

A STUDY OF CLINICAL CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING AT JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 73-74
Author(s):  
Archana Jha ◽  
Satyendra Kumar ◽  
[Prof.] Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Clinical Impression ◽  
Histopathological Diagnosis ◽  
Endometrial Sampling ◽  
Carcinoma Of Cervix ◽  
Perimenopausal Women ◽  
Pathological Evaluation

Background: Abnormal uterine bleeding in perimenopausal women accounts for about 70% of gynaecologic Outpatient Department visits. Perimenoppause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more or less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Polymenorrhagia, intermenstrrual bleeding and metrorrhagia are other common disorders at perimenopause. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding after ruling out medical causes. The present study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with clinical diagnosis and histopathological examinations. A total of 150 perimenopausal Material and Methods: women with abnormal uterine bleeding in the age group of 37-51 years for a period of 6 months were included. These women were evaluated clinically and ultrasonographically for the cause of abnormal uterine bleeding. Clinical impression and USG reports were correlated. These women underwent dilatation and curettage for endometrial sampling and specimen sent for histopathological examination. Histopathological reports were correlated with clinical diagnosis. Most of the patients with AUB were Results: between 37-41 years of age (56%). The incidence was high in parity-3 (26%) annd grand multipara (49.33%). The majority of the women were presented with menorrhagia (54.66%). Clinically, majority of the cases were diagnosed as broids 66 (44%) followed by dysfunctional uterine bleeding (DUB) 56 (37.33%). However, histopathological reports conrmed broid in 52 cases, DUB in 49, adenomyosis in 36 and polyp in 11 cases. Fibroi Discussion: ds are common nding in women with menorrhagia. Clinical, radiological and pathological evaluation correlated very well to diagnose broids and DUB. However clinically as well USG proved of little help to diagnose adenomyosis and carcinoma of cervix and endometrium. Thus, histopathological evaluation of endometrium is recommended in perimenopausal women.

scholarly journals A prospective study of comparison between transvaginal sonogram and histopathological examination in perimenopausal women with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4233
Author(s):  
P. Rishma Priyanka ◽  
C. Rama Mani ◽  
A. Yamuna
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Main Concern ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Histopathological Report

Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.

scholarly journals A descriptive study of Endometrial Biopsies in perimenopausal women having Abnormal uterine bleeding

2021 ◽  
Vol 6 (3) ◽  
pp. 203-205
Author(s):  
Sandhya I ◽  
Manjushree Prabhu P ◽  
Purnima S Rao ◽  
Sameeksha Alwa
Keyword(s):  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
Secretory Endometrium

Abnormal uterine bleeding (AUB) is one of the commonest symptom with which the perimenopausal female visits the gynaecologist accounting for over 70% of all gynecological consultations in that age group. The clinical presentation of AUB can range anywhere menorrhagia, polymenorrhea, polymenorrhagia, metrorrhagia, and menometrorrhagia. Though biopsy is the gold standard it is an invasive procedure and hence often an Ultrasound is used to evaluate the pathology of the endometrium routinely hence, we decided to study the accuracy between radiological ET thickened and its usefulness in detecting endometrial pathology. This study was carried out in the Department of Pathology at AJIMS, Mangalore for a period of 2 years. The sample included endometrial biopies and hysterectomy specimens of perimenopausal women for AUB. The ultrasonographic findings and Histopathological (HPE) reports were analysed. Among 101 cases for AUB, 67 cases were diagnosed as non secretory endometrium. Out of these 67 cases, 49 cases were associated with fibroids. Out of the rest of the AUB cases, 31 of them were diagnosed to have endometrial hyperplasia and 3 cases were diagnosed to have endometrial carcinoma. USG thickness of 17(54%) out of 31 endometrial hyperplasia cases were abnormal. Radiological and pathological evaluation were concordant with diagnosis of AUB associated with fibroids. However only 54% of the endometrial hyperplasia were found to have abnormal endometrial thickness. Radiological evaluation of endometrial thickness is not concordant in 46 % of the cases. This implies that histopathological examination is gold standard diagnostic tool for endometrial abnormalities in perimenopausal women.

scholarly journals Histopathological evaluation of endometrial sampling in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (8) ◽  
pp. 3180
Author(s):  
Bhavani L. Nair ◽  
Lency S. Kuriakose
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Endometrial Sampling ◽  
Medical College ◽  
Perimenopausal Women ◽  
Proliferative Endometrium ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the common symptoms in the gynaecology outpatient department. About one third of women are affected at some time in their lives. The perimenopausal women show significant number of underlying organic pathology. The evaluation of endometrium and/or organ histopathology has the dual advantage of finding the cause of AUB and to rule out endometrial cancer or the potential for cancer in future like endometrial hyperplasia with atypia. The aim of the study was to determine the histopathological pattern of endometrial sampling in perimenopausal women with AUB and to follow them up for a period of six months after the procedure.Methods: The prospective observational study was conducted at the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, Kerala, for a period of one year from December 2019 to December 2020. The study was conducted on 116 perimenopausal women 41-52 years who presented with AUB and had undergone endometrial sampling. These ladies were subsequently followed up for six months post procedure to assess the response to medical treatment or the need for any surgical intervention like hysterectomy.Results: A total 39.65% patients had heavy and prolonged menstrual bleeding and 18.16% patients had irregular bleeding. 14.65% patients had prolonged flow, 8.6% had heavy flow, 6.8% had infrequent with prolonged flow, 6% had prolonged, infrequent with heavy bleeding. Non-structural (COEIN) causes contributed to about 60.4% of AUB in perimenopausal women and 39.6% had structural (PALM) causes. 49% cases were secretory endometrium. 29.3% had disordered proliferative endometrium, 4.3% had proliferative endometrium, 5.2% each had polyp or hyperplasia without atypia. 18 (15.5%) cases underwent hysterectomy, 3 patients who had adenocarcinoma underwent staging laparotomy, 2 patients had LNG IUS insertion and 40 patients were on follow up requiring either no treatment and 53 (45.68%) patients were given antifibrinolytics or hormonal therapy.Conclusions: Heavy and prolonged menstrual bleeding was the most common presenting symptom. COEIN contributed to about 60.4% of cases. Evaluation of the endometrium showed that, secretory endometrium was commonest (49%) followed by disordered proliferative endometrium (29.3%). On follow up for six months, 15.5% patients underwent hysterectomy, 2 patients had insertion of levonorgestrel IUD, 45.68% patients had medical management with antifibrinolytics or hormones and were on follow up. The responsibility of gynaecologist in the management of AUB in perimenopausal women is to exclude hyperplasia of endometrium and endometrial cancer.

scholarly journals Co-relation of endometrial thickness by transvaginal sonogram with histopathology pattern in abnormal uterine bleeding: a study from South India

2020 ◽  
Vol 9 (4) ◽  
pp. 1416
Author(s):  
Chippy Tess Mathew ◽  
Uma Maheswari ◽  
Karthikeyan Shanmugam
Keyword(s):  
Precancerous Lesions ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Sampling ◽  
Dilatation And Curettage ◽  
Number Of Patients ◽  
Fourth Decade ◽  
Proliferative Endometrium

Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.

scholarly journals Histopathological study of endometrium in abnormal uterine bleeding

2012 ◽  
Vol 2 (4) ◽  
pp. 297-300 ◽  
Author(s):  
S Bhatta ◽  
AK Sinha
Keyword(s):  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Histopathological Study ◽  
Endometrial Sampling ◽  
Proliferative Endometrium ◽  
Malignant Lesions ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).Conclusion: Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

scholarly journals Endometrial pathology in abnormal uterine bleeding

2019 ◽  
Vol 7 (10) ◽  
pp. 3762
Author(s):  
Indu Rajagopal ◽  
Beena Mary Thomas ◽  
Vidyadhar N.K. Rama Rao
Keyword(s):  
Histopathological Examination ◽  
Wide Spectrum ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Accurate Analysis ◽  
Normal Endometrium ◽  
Endometrial Sampling ◽  
Medical College ◽  
Diagnostic Step

Background: Abnormal uterine bleeding (AUB) is a common presenting symptom in gynecological outpatient department. Endometrial sampling could be used as the first diagnostic step in AUB. Aim of our study was to evaluate the endometrial causes of AUB and to observe the incidence of various pathology in different age groups.Methods: A study was conducted on 167 patients who presented with AUB, during the period from July 2015- January 2017.All endometrial curettage and hysterectomy specimens received in the Department of Pathology, Kannur Medical College during  this  period  were included.Results: Maximum numbers of patients were in the perimenopausal age group and normal cycling endometrium was the commonest pattern observed (41.3%).Abnormal patterns noted were hyperplasia without atypia (20.9%), disordered proliferative pattern (16.1%) and endometrial carcinoma (1.7%).Conclusion: Histopathological examination of endometrium showed wide spectrum of lesions from normal endometrium to malignancy. Accurate analysis of endometrial sampling is important in the management of AUB.

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