A prospective randomised comparison of surgical treatment and expectant management of intrauterine polyps/fibroids in premenopausal women with abnormal uterine bleeding in an office hysteroscopy setting

2012 ◽  
Author(s):  
Kevin Phillips
Keyword(s):  
Surgical Treatment ◽  
Expectant Management ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Office Hysteroscopy

scholarly journals Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Prediction Model ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Stepwise Logistic Regression ◽  
Simultaneous Presence ◽  
Endometrial Pathology

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

scholarly journals Practice points in gynecardiology: Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy

Maturitas ◽  
2015 ◽  
Vol 82 (4) ◽  
pp. 355-359 ◽  
Author(s):  
Angela H.E.M. Maas ◽  
Mia von Euler ◽  
Marlies Y. Bongers ◽  
Herbert J.A. Rolden ◽  
Janneke P.C. Grutters ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Oral Anticoagulant ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

scholarly journals Correlation of body mass index and abnormal uterine bleeding in premenopausal women

2020 ◽  
Vol 9 (11) ◽  
pp. 4640
Author(s):  
Kumarasamy Akalyaa ◽  
Pattacheravanda Nanaiah Shakuntala ◽  
Ramaiah Renuka
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Body Mass ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Significant Difference ◽  
Menstrual Patterns ◽  
The Mean

Background: As the rate of obesity is increasing in women in the recent years, the incidence of endometrial cancer increases as the body mass index (BMI) increases. Despite the clear evidence linking endometrial cancer and obesity, there is limited public awareness of this relationship. This study was undertaken to evaluate the association of BMI and endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB).Methods: An analytical case control study was conducted in 100 women between the age group of 40 to 55, with AUB in the Department of Obstetrics and Gynecology, ESIC-PGIMSR Bangalore between January 2018 and June 2019. The menstrual patterns and endometrial pattern by histopathology were analysed in women with BMI of 18.5 to 24.99 and ≥25.Results: The mean age of women participated in the study group of between 40- 55 years was 44.83. The mean duration of symptoms was 10.18 months in the cases group and 8.52 months in the control group. The menstrual patterns were comparable and there was no significant difference in both the groups. The mean endometrial thickness, mean BMI, hyperplasia with or without atypia were all higher in the cases group. The frequency of occurrence of atypical endometrial hyperplasia was higher in women with increasing BMI.Conclusions: We found increased BMI to be an important independent risk factor for the development of endometrial hyperplasia with atypia which is a precursor to endometrial carcinoma in premenopausal women with AUB. 

scholarly journals Recent trends in managing abnormal uterine bleeding

2021 ◽  
Vol 10 (4) ◽  
pp. 1742
Author(s):  
Shruthi Ananthula ◽  
Ushadevi Gopalan ◽  
Sivan Kumar Kumarapillai
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Major Surgery ◽  
High Morbidity ◽  
Management Options ◽  
Mesh Terms

Abnormal uterine bleeding is one of the most common problems among women of reproductive age. It is an important health care problem and may cause physiological as well as psycological stress impairing the quality of life. The aim of this review was to present various management options for women suffering from menorrhagia. An extensive electronic literature search was done using search engines like PubMed and Google scholar using the mesh terms/ key words like “abnormal uterine bleeding, menorrhagia, medical management, hysterectomy” to identify trials and reviews on management of abnormal uterine bleeding. Various pharmacological and surgical treatment options are available, among medical therapy Tranexamic acid being most effective. Second-generation endometrial ablation techniques are effective and safe alternatives compared to first-generation devices. Hysterectomy should be considered as a last resort in management of AUB as this major surgery is associated with high morbidity and mortality rates. Thus role of clinician is to counsel every women and provide full information regarding both medical as well as surgical treatment modalities available and facilitate them in making an appropriate choice.

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