STUDY OF ENDOMETRIAL PATHOLOGY IN ABNORMAL UTERINE BLEEDING IN A TERTIARY CARE CENTRE

Background: Abnormal uterine bleeding is one of the commonest conditions amongst patients attending gynaecology OPD which also leads to significant disruption in a normal lifestyle. The causes of abnormal uterine bleeding are heterogeneous and complex. A systematic evaluation with detailed history and physical examination is foremost important in reaching diagnosis. Hysteroscopy is not only safe, quick and observes entire uterine cavity but also helps in precision in sampling and increases accuracy of diagnosis. It is also curative in conditions such as polyps, fibroids, uterine synechiae, menorrhagia and lost intrauterine contraceptive device. The aim of the study is to evaluate the role of hysteroscopy as a screening method in patients with AUB & compare to their USG findings and to the histopathological reports of the endometrial biopsy.Methods: This is a prospective observational study conducted at a tertiary healthcare centre over a period of 18 months, in 50 females belonging to pre, peri and post-menopausal age group. Sampling was done based on selection criteria after obtaining valid consent from the study group.Results: Hysteroscopy has a definitive role in evaluation of patients presenting with abnormal uterine bleeding with high sensitivity, specificity, PPV and NPV with immediate results.Conclusions: The above study concludes that the accuracy of diagnosing the cause of abnormal uterine bleeding is more with hysteroscopy followed by D and C then USG combined with D and C.

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Prevalence of adenomyosis and associated gynaecological pathologies in hysterectomy samples: a retrospective study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213203 ◽

2021 ◽

Author(s):

Lekshminath Gopinath ◽

Rajani Vaidya

Keyword(s):

Tertiary Care ◽

Abnormal Uterine Bleeding ◽

Serous Cystadenoma ◽

Uterine Bleeding ◽

Research Centre ◽

Common Symptom ◽

Age Group ◽

Tertiary Care Centre ◽

College Hospital ◽

Case Record

Background: Adenomyosis is a prevalent gynaecological disorder among women and it is a major cause for AUB. Its diagnosis is confirmed by histological examination of hysterectomized samples. Moreover it is associated with other benign gynaecological pathologies. The aim of this study is to identify the prevalence of Adenomyosis and its association with other benign gynaec pathologies in hysterectomized samples.Methods: This retrospective of two year duration was conducted in obstetrics and Gynaecology department of Malabar Medical College Hospital and Research Centre, a tertiary care centre in Kozhikode, Kerala from 2019 June to 2021 June. 452 patients underwent hysterectomy for abnormal uterine bleeding during this period. Among this, 76 patients had histologically proven adenomyosis in hysterectomy specimen and their case record were reviewed and the data was analysed.Results: The prevalence of Adenomyosis in this study was 16.8%. Majority of women were in age group of 41 to 46 (36.8%), followed by 46 to 50 age group (26.3%). 94 % of women were multipara with majority in para2 and para3 group. Only 6 % of women were nulliparous. Most common symptom was abnormal uterine bleeding (92%), followed by dysmenorrhoea and chronic pelvic pain. Majority had overlap of symptoms. 7% of women were asymptomatic. In 60 % of women no other gynaec pathologies were identified. Most common associated pathology was leiomyoma (15.8%), closely followed by endometriosis (13.2%). Endometrial hyperplasia was associated with adenomyosis in 3.9%of women and endometrial polyp in 2.6%. Ovarian pathologies identified were simple ovarian cyst (2.6%) and serous cystadenoma (1.3%).Conclusions: In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Among the associated gynaec pathologies, leiomyoma had the highest correlation with adenomyosis.

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Hysterectomy for benign conditions in a tertiary care centre: a clinical audit

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210719 ◽

2021 ◽

Vol 10 (3) ◽

pp. 975

Author(s):

K. Hymavathi ◽

P. V. Sreeleena Madhuri ◽

Maddipudi Brahmini ◽

Sakthi Madhubala

Keyword(s):

Clinical Audit ◽

Economic Status ◽

Tertiary Care ◽

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre

Background: This clinical audit is to determine the indications, type, and outcome of hysterectomy performed for benign gynaecological conditions in two years and to identify the problem or issue (if any) in planning the hysterectomy for benign conditions.Methods: The present study is a hospital-based prospective study conducted in the Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, a tertiary care centre, Nellore, AP. Six hundred women, who underwent the hysterectomy during the study period are recruited into this study after obtaining hospital ethical committee approval and informed consent. Among the total of 50,450 women attended our OPD for gynaecological complaints, 600 patients underwent the hysterectomy. Thus 9.6% of total gynaecological admissions ended up with the hysterectomy.Results: The mean age group of the study is 49.07±8.0 years. Majority of women belonged to low socio-economic status. Predominant age group underwent hysterectomy was 40-49 years. Majority (78.2%; 469 cases) of hysterectomies were done in multiparous women. Chief complaints were menstrual irregularities. Abnormal uterine bleeding -leomyoma (AUB-L) (228 cases; 38%) was the most common indication for hysterectomy. Most commonly done procedure was total abdominal hysterectomy TAH (60.5%; 363 cases). 306 cases (51%) had oophorectomy (beyond the age of 45 years).The various complications (hemorrhage, sepsis etc..) found to happen mainly in hysterectomies done through abdominal route. 95% of hysterectomised histopathological specimen’s histopathology reports correlated with the pre-operative biopsy reports.Conclusions: In proved benign conditions, women were counselled and encouraged for medical and conservative methods. Hysterectomies should be decided in those situations where the above measures fail and also where it was found to be the definitive management in the first instance. Woman’s option has also to be considered in certain cases. The route of hysterectomy has to be decided case to case basis and choice of the attending clinician. Oophorectomy was decided in the premenopausal women depending on the condition of the ovaries witnessed at the time of surgery.

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