scholarly journals Chronic endometritis is an indication for the pregravid preparation

2018 ◽  
Vol 9 (2) ◽  
pp. 36-41 ◽  
Author(s):  
G. M. Savelyeva ◽  
S. A. Mikhalev ◽  
A. G. Konoplyannikov ◽  
L. M. Mikhaleva ◽  
I. I. Babichenko ◽  
...  
Keyword(s):  
Blood Circulation ◽  
Bacterial Culture ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Cervical Canal ◽  
Chronic Endometritis ◽  
Comprehensive Examination

The crucial role of chronic endometritis in the genesis of endometrial dysfunction has been currently established. The inflammatory process serves as a co-factor and leads to a decrease in the receptivity of the sex hormones of the endometrium due to impaired blood circulation of the tissue and fibrosis in the stroma of the endometrium. This article is devoted to the study of the morpho-functional state of the endometrium in women of the reproductive age with abnormal uterine bleeding, in whom endometritis was diagnosed pathomorphologically, which is important for clarifying indications for the pregravid preparation in the future. A comprehensive examination of patients with abnormal uterine bleeding includes: bacterial culture (PCR) of the cervical canal and uterine cavity, hormonal profile, ultrasound examination of the pelvic organs and a complex histological examination of the uterine biopsy at the 7–10th and 19–21st days of the menstrual cycle, followed by immunohistochemical examination with the use of antibodies to the receptors of estrogens and progesterone, glycodelin, CD138, CD4, CD8, CD20.

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.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

scholarly journals Role of Ultrasound in the Evaluation of Abnormal Vaginal Bleeding in Nonpregnant Patients in Reproductive Age

2012 ◽  
Vol 6 (1) ◽  
pp. 112-120
Author(s):  
Bailey Wilson ◽  
Sanja Kupesic Plavsic
Keyword(s):  
Vaginal Bleeding ◽  
Obstet Gynecol ◽  
Color Doppler ◽  
Abnormal Uterine Bleeding ◽  
Color Doppler Ultrasound ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Ultrasound Findings ◽  
Abnormal Vaginal Bleeding

ABSTRACT Abnormal uterine bleeding is defined as any alteration in the volume, pattern or duration of menstrual blood flow. Abnormal uterine bleeding can be due to a number of organic and dysfunctional causes. This article presents different case scenarios of nonpregnant reproductive age patients presenting with abnormal genital tract bleeding. These cases will allow the reader to identify differential diagnoses related to each scenario and to understand ultrasound findings typical for nonpregnant patients presenting with abnormal vaginal bleeding. The role of B-mode and color Doppler ultrasound in the evaluation of abnormal uterine bleeding is described. Standard treatment methods are also listed for each case. How to cite this article Wilson B, Plavsic SK. Role of Ultrasound in the Evaluation of Abnormal Vaginal Bleeding in Nonpregnant Patients in Reproductive Age. Donald School J Ultrasound Obstet Gynecol 2012;6(1):112-120.

scholarly journals Role of diagnostic hysteroscopy in evaluating patients with abnormal uterine bleeding in a tertiary care centre

2021 ◽  
Vol 10 (12) ◽  
pp. 4464
Author(s):  
Apeksha M. Mohite ◽  
Deepali S. Kapote ◽  
Michelle Fonseca
Keyword(s):  
Tertiary Care ◽  
Screening Method ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Uterine Bleeding ◽  
Systematic Evaluation ◽  
Contraceptive Device ◽  
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.

scholarly journals The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Attilio Di Spiezio Sardo ◽  
Gloria Calagna ◽  
Fabrizia Santangelo ◽  
Brunella Zizolfi ◽  
Vasilis Tanos ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Incidental Finding ◽  
Imaging Techniques ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Uterine Adenomyosis ◽  
Improving Accuracy

Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control. Hysteroscopy is not a first-line treatment approach for adenomyosis and it represents a viable option only in selected cases of focal or diffuse “superficial” forms. During office hysteroscopy, it is possible to enucleate superficial focal adenomyomas or to evacuate cystic haemorrhagic lesions of less than 1.5 cm in diameter. Instead, resectoscopic treatment is indicated in cases of superficial adenomyotic nodules > 1.5 cm in size and for diffuse superficial adenomyosis. Finally, endometrial ablation may be performed with the additional removal of the underlying myometrium.

scholarly journals Hysteroscopy in evaluation of intrauterine causes of abnormal uterine bleeding

2020 ◽  
Vol 8 (10) ◽  
pp. 3694
Author(s):  
Nikita Gandotra ◽  
Isha Sunil ◽  
Shazia Zargar
Keyword(s):  
Medical Records ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histopathological Diagnosis ◽  
Cervical Canal ◽  
Common Symptom ◽  
Age Group ◽  
Easy Method ◽  
Obstetrics And Gynaecology

Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause.Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected intrauterine abnormality in 59% cases. Most common being hyperplastic endometrium in 52 patients (26%) followed by polyp (20%). 14 (7%) had sub mucous fibroid, 8 (4%) had atrophic endometrium and 2 (1%) had intrauterine adhesions.Conclusion: Hysteroscopy provides a simple & easy method for visualization of the cervical canal & uterine cavity for the evaluation of AUB. Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.

scholarly journals Role of office hysteroscopy in gynecology: retrospective observational study at a tertiary care hospital

2016 ◽  
Vol 6 (1) ◽  
pp. 111
Author(s):  
Manoj Kumar Tangri ◽  
Prasad Lele ◽  
Krishan Kapur ◽  
Anupam Kapur ◽  
Neelam Chhabra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Outpatient Department ◽  
Cervical Canal ◽  
Care Hospital ◽  
Office Hysteroscopy ◽  
Tertiary Care Centre ◽  
Office Setting

Background: Hysteroscopy being the gold standard for evaluation of uterine cavity can be utilized for varied gynaecological indications. Conventionally, hysteroscopy is performed under general anaesthesia but with technical advances over years, it is now possible to do the procedure in ambulatory office setting with same diagnostic accuracy. Aim of this study was to assess the role of hysteroscopy as a diagnostic tool in office setting, to evaluate various gynaecological conditions.Methods: Study performed retrospective analysis on 1920 patients who underwent office hysteroscopy between Jan 2011 to Apr 2015, at outpatient department of a tertiary care centre at Maharashtra, India. The procedure was done in office setting without any sedation or anaesthesia. Approach used was vaginoscopic free hand technique with minimal instrumentation and the findings were documented after evaluation of uterine cavity, ostea and endocervical canal.Results: Office hysteroscopy could be successfully performed in 1920 out of 1938 patients. Most common indications were primary infertility (38.0%), secondary infertility (11.2%), abnormal uterine bleeding (36.6%) and postmenopausal bleeding (8.3%). The procedure done in office setting was tolerated well. The procedure was also used for evaluation in patients with breast and endometrial carcinoma.Conclusions: Office hysteroscopy by vaginoscopic approach is a simple and convenient method for evaluation of uterine cavity and cervical canal. It has the potential to come out from formal operation theatre to more patient friendly outpatient department.

Krwawienia młodocianych i inne problemy związane z krwawieniami w ginekologii – z uwzględnieniem aspektów medycyny rodzinnej

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Grażyna Jarząbek-Bielecka ◽  
Wojciech Trusz ◽  
Grzegorz Bręborowicz ◽  
Witold Kędzia ◽  
Małgorzata Mizgier
Keyword(s):  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Outpatient Clinics ◽  
Developmental Age ◽  
Life Threatening ◽  
Specialist Treatment ◽  
Abnormal Bleeding ◽  
Gynecological Care

The issue of uterine bleeding is important not only in gynecology, but also in family medicine. Patients with abnormal uterine bleeding often report to family doctor's outpatient clinics. However, such situations usually require further specialist gynecological care – abnormal uterine bleeding is the most common cause of hospitalization of women in gynecological wards. These patients need detailed diagnosis, and many of them require hospitalization and specialist treatment. The problem of heavy uterine bleeding also affects patients of developmental age, with juvenile bleeding (metrorrhagia iuvenilis) being a particular issue here. This is acyclic bleeding in girls that lasts over 10 days up to 3 months. These bleeds are very heavy and prone to relapse. They can cause anemia. Severe cases and other hemorrhages in gynecology can be life-threatening. Most often pathological changes in the uterine cavity may manifest as abnormal bleeding concern menstruating patients ar reproductive age, as well as those in the peri- and postmenopausal period. However, juvenile bleeding is an important problem in gynecology

scholarly journals Assessing cytokine status of patients with chronic endometritis combined with endometrial hyperplastic processes in reproductive period

2020 ◽  
Vol 10 (4) ◽  
pp. 762-768
Author(s):  
L. V. Tkachenko ◽  
N. I. Sviridova ◽  
N. A. Zharkin ◽  
N. A. Burova ◽  
E. B. Belan
Keyword(s):  
Histological Examination ◽  
Inflammatory Process ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cytokine Level ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cervical Canal ◽  
Chronic Endometritis ◽  
Group I ◽  
Group Ii

The goal of our study was to examine local and serum cytokine level involved in regulating inflammation in patients with chronic endometritis combined with endometrial hyperplastic processes. On admission, all patients underwent hysteroscopy with separate diagnostic curettage followed by histological examination of samples isolated from the uterine and cervical canal mucosa. Such manipulations were indicated due to abnormal uterine bleeding as well as suspected endometrial pathology based on ultrasound examination. According to the histological examination data of the endometrial samples, all patients were divided into two groups: group I contained 45 women with CE combined with PEG without atypia; group II — 38 patients with morphologically verified CEE combined with AEG without atypia. Level of IL-1P, IL-2, IL-6, IFNy, TNFa in biological fluids (aspirate from the uterus; serum) was measured by using enzyme-linked immunosorbent assay. We found that in both groups (91.1% and 89.6%, respectively) the vast majority of patients was hospitalized due to abnormal uterine bleeding. Oligomenorrhea alternated with intermenstrual bleeding (66.7% and 71.2%, respectively) and dominated in pattern of menstrual cycle disorders in the examined patients, whereas 11 (24.4%) and 7 (18.4%) patients from group I and II, respectively, were noted to suffer from severe menstrual bleeding. Overall, analyzing the data on cytokine level both in the uterine aspirate and serum evidences about ongoing inflammatory process found at examination time point. Upon that, such process was not only local, but also exhibited signs of a systemic inflammatory response. The data on cytokine level in the uterine aspirate from patients with CE coupled to PGE or CGE without atypia point at local inflammatory process characterized by significantly increased concentration of IL-ф, IL-2, IL-6, TNFa and IFNy. At the same time, higher level of IL-ф and IFNy in patients from group II might indicates that degree of morphological changes in the endometrium could affect the level of local cytokine production. Thus, the data obtained evidence that immune changes in chronic endometritis combined with non-atypical endometrial hyperplastic processes mostly occur locally. In this regard, measuring cytokine concentration in the uterine aspirate is a diagnostic predictor and serves as a sign for monitoring therapeutic effectiveness of therapy in this cohort of patients.

The scattered puzzle effect: implantation disorders in chronic endometritis

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 93-100
Author(s):  
Victor E. Radzinsky ◽  
Mekan R. Orazov ◽  
Liliia R. Toktar ◽  
Liudmila M. Mihaleva ◽  
Pavel A. Semenov ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Special Role ◽  
Inadequate Response ◽  
Chronic Endometritis ◽  
Vitro Fertilization ◽  
Endometrial Cells ◽  
Adverse Pregnancy ◽  
Relationship Of

Chronic endometritis (CE) is defined as a state of inflammation localized in the endometrium, accompanied by edema, dissociated maturation of epithelial cells and fibroblasts, increased stromal density and the presence of plasma cell infiltrate in it. The connection between chronic inflammation in the endometrium and infertility deserves special attention. Inadequate response of immunocompetent endometrial cells, including impaired synthesis of proinflammatory cytokines, dysreceptiveness, disorders of proliferation and differentiation processes are the main links in the formation of infertility in patients with CE. Despite the fact that the presence of a normocenosis of the uterine cavity today is not in doubt this is a physiological norm, persistent bacterial infection of the endometrium is still called the main etiopathogenetic factor of CE and, therefore, the main point of application of therapeutic agents. Nevertheless, a number of works have emphasized the special role of not bacterial, but viral etiology of endometritis, especially in the context of infertility developing against this background. It seems that the role of viral endometrial infection in adverse pregnancy outcomes and in vitro fertilization programs is underestimated. Further research is needed to clarify the relationship of viral infection as a trigger of implantation failure in infertile women with CE.

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