scholarly journals Clinical bleeding patterns and management techniques of abnormal uterine bleeding at a teaching and referral hospital in Western Kenya

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243166
Author(s):  
Godfrey Shichenje Mutakha ◽  
Emily Mwaliko ◽  
Philip Kirwa
Keyword(s):  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Referral Hospital ◽  
Reproductive Age ◽  
Laboratory Evaluation ◽  
Cross Sectional ◽  
Western Kenya ◽  
Prolonged Bleeding ◽  
Diagnostic Guideline

Abnormal uterine bleeding (AUB) affects 30% of reproductive age women globally. However, there are limited local studies evaluating the management of these women. The diagnostic guideline using structural and functional causes of AUB adopts the PALM-COEIN criteria, namely: Polyp; Adenomyosis; Leiomyoma; Malignancy and Hyperplasia; Coagulopathy; Ovulatory dysfunction; Endometrial; Iatrogenic; and Not yet classified. This study aimed to determine the clinical bleeding patterns, adherence to PALM-COEIN diagnosis guidelines and management of AUB among women in their reproductive age. This was a cross-sectional study among 108 women with AUB aged 18–45 years was conducted at the gynaecology department of Moi Teaching and Referral Hospital in Western Kenya between April 2018 and April 2019. Their sociodemographic and clinical characteristics were collected using interviewer administered structured questionnaire and chart reviews. Adherence to diagnosis recommendations was assessed using PALM COEIN classification. Descriptive and inferential data analysis was conducted at 95% confidence interval. The median age was 30 (IQR: 22, 41) years with prolonged bleeding as the most predominant pattern at 41.7%. Bleeding patterns were significantly associated with age (p = 0.04). Only 16.7% were diagnosed as per the PALM-COEIN criteria with PALM and COEIN accounting for 60% and 40% respectively. Leiomyoma (44.5%) was the common cause of AUB. Laboratory evaluation included: pregnancy tests, full haemogram, hormonal profile and biopsy. Most (79.6%) of the women had abdominopelvic ultrasound done. Medical management was provided for 78.7% of women. Prolonged bleeding was the most common pattern with medical management preferred. There is need for in-hospital algorithms to ensure adherence to PALM-COEIN guidelines.

scholarly journals CLINICAL BLEEDING PATTERNS AND MANAGEMENT TECHNIQUES OF ABNORMAL UTERINE BLEEDING IN WESTERN KENYA.

2020 ◽  
Author(s):  
Godfrey Shichenje Mutakha ◽  
Emily Mwaliko ◽  
Philip Kirwa
Keyword(s):  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Laboratory Evaluation ◽  
Cross Sectional ◽  
Western Kenya ◽  
Prolonged Bleeding ◽  
Diagnostic Guideline

ABSTRACTBackgroundAbnormal uterine bleeding (AUB) affects 30% of reproductive age women globally. However, there are limited local studies evaluating the management of these women. The diagnostic guideline using structural and functional causes of AUB adopts the PALM-COEIN criteria, namely: Polyp; Adenomyosis; Leiomyoma; Malignancy and Hyperplasia; Coagulopathy; Ovulatory dysfunction; Endometrial; Iatrogenic; and Not yet classified. This study aimed to determine the clinical bleeding patterns and management of AUB among women in their reproductive age.MethodsA cross-sectional study among 108 women with AUB aged 18-45 years was conducted at the gynaecology department of Moi Teaching and Referral Hospital in Western Kenya between April 2018 and April 2019. Their sociodemographic and clinical characteristics were collected using interviewer administered structured questionnaire and chart reviews. Adherence to diagnosis recommendations was assessed using PALM COEIN classification. Descriptive and inferential data analysis was conducted at 95% confidence interval.ResultsThe median age was 30 (IQR: 22, 41) years with prolonged bleeding as the most predominant pattern at 41.7%. Bleeding patterns were significantly associated with age (p = 0.04). Only 16.7% were diagnosed as per the PALM-COEIN criteria with PALM and COEIN accounting for 60% and 40% respectively. Leiomyoma (44.5%) was the common cause of AUB. Laboratory evaluation included: pregnancy tests, full Haemogram, hormonal profile and biopsy. Most (79.6%) of the women had abdominopelvic ultrasound done. Medical management was provided for 78.7% of women.ConclusionProlonged bleeding was the most common pattern with medical management preferred. There is need for in-hospital algorithms to ensure adherence to PALM-COEIN guidelines.

scholarly journals Thyroid abnormality in abnormal uterine bleeding: an observational study from Medical College in Eastern UP, India

2017 ◽  
Vol 7 (1) ◽  
pp. 308
Author(s):  
Prachi Singh ◽  
Prashant Dubey ◽  
Shweta Yadav ◽  
Sachin Singh Yadav
Keyword(s):  
Observational Study ◽  
Thyroid Function ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Medical College ◽  
Hormonal Imbalance ◽  
Euthyroid Status

Background: Abnormal Uterine Bleeding (AUB) is one of the commonest gynecological complain in reproductive age group. Menstrual abnormalities are commonly seen when there is any alteration in thyroid function. Objective of present study was to investigate the prevalence of AUB and to determine the menstrual pattern in cases with thyroid dysfunction.Methods: The present cross sectional observational study was conducted Teerthankar Mahaveer Medical College and Research Center Moradabad. Total 400 cases presenting with AUB were included in the study. Routine blood test, ultrasonography and thyroid function tests were done in these cases.Results: Among all the cases presenting with menstrual abnormalities 26% had hypothyroidism and 9% have hyperthyroidism and rest had euthyroid status. Menorrhagia (45.2%) and polymenorrhoea (37.5%) were commonest menstrual abnormality seen in cases with hypothyroidism. Most cases with hyperthyroidism presented with hypomenorrhoea (27.8%).Conclusions: Thyroid function abnormality is common in cases presenting with AUB and it gets relieved in correcting hormonal imbalance.

scholarly journals Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age

2020 ◽  
Vol 9 (7) ◽  
pp. 2792
Author(s):  
Hema K. R. ◽  
Girish B. L. ◽  
Dhananjaya B. S. ◽  
Riyaj Ahmad Kalaburgi
Keyword(s):  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
Thyroid Profile ◽  
Definitive Management

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.

Symptoms of Uterine Dystemperament in Abnormal Uterine Bleeding from Perspective of Persian Medicine

2019 ◽  
Author(s):  
Fatemeh Moradi ◽  
Fatemeh Alizadeh ◽  
Nafiseh Zafarghandi ◽  
Farhad Jafari ◽  
Mahdi Alizadeh Vaghasloo ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Positive Symptoms ◽  
Uterine Hemorrhage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Persian Medicine ◽  
Medical Referral

Abnormal Uterine Bleeding (AUB) is the most common reason for women’s medical referral in the reproductive age. In Persian Medicine, one of the major causes of this disorder is known as uterine dystemperament (Su-e-Mizaj). AUB is known as “Kesrat-e Tams” in this medical school. We aimed to investigate the frequency of positive symptoms of uterine dystemperament in patients with AUB from the perspective of Persian Medicine. This cross-sectional study was conducted from October 2009 to September 2010 in Tehran, Iran. It comprised 70 patients with abnormal uterine bleeding who were 15-45 years old. Data were collected by a questionnaire prepared based on the textbooks of Persian Medicine. The frequency of each symptom of uterine dystemperament was obtained. Among the four uterine dystemperaments, the “dry” and “warm” uterine types had the highest rankings. In patients with excess uterine hemorrhage, the symptoms of warm uterine is more frequent than cold uterine. Meanwhile, the warm uterine dystemperament interference was also observed in excess uterine hemorrhage.

scholarly journals Evaluation of Outcome Measures of Hysteroscopy Polypectomy in Women with Abnormal Uterine Bleeding

2020 ◽  
Author(s):  
Zahra Tavoli ◽  
Melika Agha Mohammad Ali Kermani ◽  
Somayeh Moradpanah ◽  
Ali Montazeri
Keyword(s):  
Outcome Measures ◽  
Abnormal Uterine Bleeding ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Partial Recovery ◽  
Cross Sectional

Introduction: The most common causes of Abnormal Uterine Bleeding (AUB) in women of reproductive age are uterine polyps. Operative hysteroscopy is the management of choice to remove polyp. However, the certainty of the treatment remains to be examined. Aim: To investigate the outcome of hysteroscopy polypectomy in women with AUB. Materials and Methods: This was a cross-sectional study on the samples of women with AUB who underwent a hysteroscopy polypectomy. Patients were assessed pre and postoperatively and were asked to respond to a number of outcome measures including duration of monthly cycle, menstruation cycle, heavy menstrual bleeding, the number of pads used in day and night and improvement of inter-menstrual bleeding, postcoital bleeding, and limited activity. Pre-and postsurgery data were compared using Wilcoxon and McNemar tests. Results: In all, 83 patients were entered into the study. The mean age of participants was 41.8 (±8.37) years. The most common preoperative complaint was heavy menstrual bleeding (n=63, 76%) followed by intermenstrual bleeding (n=40, 48%). There were significant differences between preoperative and postoperative symptoms (p-values <0.05). Perceived complete recovery (n=54, 65%), partial recovery (n=13, 15.7%) and satisfaction (n=66, 79.5%) were high after hysteroscopy. Conclusion: AUB due to polyp might be improved with hysteroscopy. Further investigations are needed to confirm the results and to study on co-existence of other causes of AUB after hysteroscopy polypectomy.

scholarly journals Comparison of MR Hysterography and Sonohysterography in Women with Abnormal Uterine Bleeding: An Interventional Study

2021 ◽  
Author(s):  
Tsella Lachungpa ◽  
Radha Sarawagi ◽  
Sunitha Vellathussery Chakkalakkombil
Keyword(s):  
Cervical Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Public Health Issue ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Endometrial Pathology

Introduction: Abnormal Uterine Bleeding (AUB) is very common and major public health issue. AUB along with its sub-group often affects 14.25% women of reproductive age and have major impact on their physical, social, emotional and material quality of life. It not only has direct impact on the woman and her family, but also on both economy and health services. Aim: To compare Magnetic Resonance (MR) hysterography and Sonohysterography (SSHG) for detection of uterine pathologies in women with AUB. Materials and Methods: An interventional cross-sectional study was conducted over a period from July 2019 to July 2020, among 30 patients with severe AUB. SSHG and MR hysterography were used to assess endometrial pathology, and endometrial pathology was assessed by both the diagnostic modality and considering histopathology as gold standard. We calculate sensitivity, specificity, positive predictive value and negative predictive value for both the diagnostic modalities. Results: Very good agreement was noted in case of the cervical carcinoma whilst fibroid and endometrial hyperplasia showed good and fair agreement respectively by both the diagnostic modality. Sensitivity of fibroid and cervical carcinoma was 100%, polyp was 33.33%, and endometrial hyperplasia was 87.50%. Whereas specificity of fibroid was 91.67%, endometrial hyperplasia was 86.30% and cervical carcinoma was 100%. Polyp and submucosal fibroid both showed 96.30% specificity. For pathology like cervical carcinoma, endometrial hyperplasia, fibroid had very high agreement with kappa value 1, 0.684 and 0.814 respectively, whereas agreement for two tests for pathology like submucous fibroid, dual pathology was less. Conclusion: MR Hysterography and Sonohysterography were having almost equal sensitivity and specificity for abnormal uterine bleeding and can be used as per patient preference, patient discomfort, and availability of investigation.

scholarly journals Clinico epidemiological profile of abnormal uterine bleeding in reproductive womens: a cross sectional study

2019 ◽  
Vol 8 (11) ◽  
pp. 4395
Author(s):  
Neetu Singh ◽  
Mariyam Faruqi ◽  
Yashodhara Pradeep
Keyword(s):  
Middle Class ◽  
Health Resources ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Common Reason ◽  
Age Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Reproductive Age Group

Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. This study was done with the aim to observe the clinical and demographic profile of the patients and the pattern of AUB.Methods: It is an observational study, conducted in department of obstetrics and gynaecology, DR Rammanohar Lohia institute of medical sciences, Lucknow, Uttar Pradesh from August 2018 to July 2019. All patients in the reproductive age group with symptoms of abnormal uterine bleeding were included in the study.Results: Majority (37.50%) of the women were in the age group of 30-40 years. 71.66% were multiparous and maximum women (60%) were in normal BMI. 69.17% were belonging to middle class. Commonest presentation was menorrhagia (48.3%) followed by oligomenorrhoea (18.1%) followed by polymenorrhoea (17.27%).Conclusions: Excessive menstrual blood loss is a common reason for women to seek medical help and leads to large demands in health resources According to our study majority of the women with AUB were in the age group of 30-40 years, were multiparous with normal BMI belonging to middle class. Commonest presentation was menorrhagia. Following study highlights the clinical and epidemiological pattern of abnormal uterine bleeding of reproductive age group, which is crucial factor in management for these patients. In order to predict causal association, further more studies with larger sample size of higher level of evidence should be conduct to draw causal evidence.

scholarly journals Clinical pattern and presentation of abnormal uterine bleeding

2019 ◽  
Vol 9 (1) ◽  
pp. 126
Author(s):  
Sarala V. ◽  
Ushadevi Gopalan
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Age Group ◽  
Cross Sectional ◽  
Anovulatory Cycle ◽  
Management Of Complications ◽  
Multiparous Women ◽  
One Year

Background: Abnormal uterine bleeding (AUB) is a very common debilitating gynecological condition among women of the reproductive age group. This diagnosis is given to women in whom no clear etiology is identified. It can occur in ovulatory and anovulatory cycle. It influences the physical, emotional, sexual and professional life of a woman. This study was carried out to evaluate the clinical profile of abnormal uterine bleeding.Methods: This cross-sectional study was carried out among 350 patients who were clinically diagnosed with AUB for a period of one year from April 2018 to March 2019. Patients with uterine polyp, adenomyosis, Leiomyoma, malignancies and with various coagulopathies were excluded from the study by physical examination, ultrasound, histopathology and blood test. The remaining 280 patients between the ages 20-60 years were selected for clinical classification of AUB.Results: Majority of the participants were in the age group of 41-50 years (60%). AUB is most commonly seen in multiparous women (48.92%). The prominent bleeding pattern seen was menorrhagia (52.2%).Conclusions: Menorrhagia is the most common form of AUB and there is a need to prevent the consequences of menorrhagia by way of creating awareness among the women, and by early diagnosis and clinical management of complications.

scholarly journals Role of Multidetector Computed Tomography (CT) Virtual Hysteroscopy in the Evaluation of Abnormal Uterine Bleeding in Reproductive Age

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Hend S. Saleh ◽  
Nadia M. Madkour ◽  
Ahmed Mahmoud Abdou ◽  
Entesar R. Mahdy ◽  
Hala E. Sherif ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Radiology Department ◽  
Cross Sectional ◽  
Endometrial Polyps

Background. Abnormal uterine bleeding (AUB) may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. It is a widespread complaint in the primary care units. The prevalence of abnormal bleeding is up to 30% among women of reproductive age. Objective. To assess the role of CT virtual hysteroscopy in the evaluation of the uterine cavity in cases with abnormal uterine bleeding in reproductive age. Methods. Cross sectional study was performed at Obstetrics and Gynecology Department and Radiology Department, Zagazig University hospitals, Egypt, on 124 women with abnormal uterine bleeding in reproductive age, and their uterine cavity was evaluated by both row multidetector computed tomography (MDCT) scanner and Office hysteroscopy. Results. Mean age of studied group was 28.54 ± 5.99 years, and virtual hysteroscopy showed sensitivity 91.1% and specificity 85.3% in detection of abnormalities within uterine cavity. It showed sensitivity 91.1% and specificity 85.3% in cases of endometrial polyps. It yielded 88.5 % sensitivity and 100 % specificity in cases with submucous fibroids, while it yielded only 57.9 % sensitivity and 82.9% specificity in cases of thick endometrium. Conclusion. Virtual CT hysteroscopy is a good negative test in cases of abnormal uterine bleeding but has some limitations that decrease its sensitivity.

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