scholarly journals Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

2017 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Histopathological Findings ◽  
Number Of Patients ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 

scholarly journals CLINICO-PATHOLOGICAL EVALUATION OF PATIENTS WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
Vol 71 (3) ◽  
pp. 870-74
Author(s):  
Rabiah Anwar ◽  
Nighat Jamal ◽  
Sobia Anwar
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Clinical Spectrum ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Cross Sectional ◽  
Gynecology And Obstetrics ◽  
Menstrual Irregularities

Objective: To evaluate clinical spectrum in women of different age groups presenting with menstrual irregularities without any organic pelvic pathology and to correlate clinical and pathological aspects in these women. Study Design: Cross sectional analytical study. Place and Duration of Study: Department of Gynecology and Obstetrics, Pakistan Naval Ship (PNS) Shifa Hospital, Karachi from Feb 2018 to Jan 2019. Methodology: Complete history, clinical examination, laboratory investigations, pelvic scan and endometrial biopsy of patients were done to diagnose abnormal uterine bleeding without organic (structural) pathology. Evaluation of clinical spectrum of menstrual irregularities in different age groups and histopathology of their endometrial samples was done. Results: A total of 184 cases were included. Mean age of patients presented with abnormal uterine bleeding was 38.49 ± 9.158. It was most common in the age group 41-50 years (41.84%) followed by 31-40 years (29.34%). Majority of them were multipara 146 (79.34%). The most common presentation was heavy menstrual bleeding (50.54%) followed by irregular menstrual bleeding (17.93%). Histopathology of endometrium revealed proliferative (41.30%) followed by hyperplastic (27.71%) and secretory (21.19%) pattern. 3.26% had atrophic endometrium and 1.63% cases had endometrial carcinoma. Conclusion: In conclusion, 41-50 year age group was mostly affected by abnormal uterine bleeding. Their menstrual pattern was heavy, irregular, frequent and prolonged. Proliferative and hyperplastic pattern of endometrium was observed in these patients.

scholarly journals Clinical and histopathological presentation of abnormal uterine bleeding in perimenopausal women in tertiary center of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 248-252
Author(s):  
Sadikchha Chapagain ◽  
Ganesh Dangal
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Clinical Feature ◽  
Age Group ◽  
Histopathological Findings ◽  
Tertiary Center ◽  
Perimenopausal Women ◽  
Proliferative Endometrium ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding is defined as any bleeding outside of normal menstruation pattern with excessive duration, frequency, and amount and it is a common problem among women of reproductive age group with varied presentations. The aim of the study was to correlate the histopathological finding in patients with abnormal dysfunctional uterine bleeding with the presenting clinical feature.Methods: A prospective cross sectional study was carried out at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu during the period of one year (February 2019 to January 2020). It included 77 perimenopausal women with abnormal uterine bleeding who presented in gynecology outpatient department and planned for dilatation and curettage. Then the participants were counselled and informed consent was taken. Histopathological reports reviewed and analysis done. Results: The most common age group of women presenting with abnormal uterine bleeding was 40 to 44 years and the commonest clinical feature was menorrhagia (31/77, 40.3%) followed by menometrorrhagia (18/77, 23.4%). Majority of women were multiparous, parity 3 to 4 (38/77, 49.4%). Proliferative endometrium (29/77, 37.7%) was most common histopathological findings followed by secretory endometrium (24/77, 31.2%). Proliferative endometrium was more commonly associated with menorrhagia and menometrorrhagia whereas secretory endometrium with metrorrhagia (P-value 0.000).Conclusions: Menorrhagia and Menometrorrhagia are the most common clinical presentation among perimenopausal women with AUB, whereas proliferative endometrium and secretory endometrium were the common histopathological findings respectively.Accurate diagnosis is crucial for a selection of relevant treatment and avoidance of unnecessary major surgical procedure. Keywords: Abnormal uterine bleeding; endometrium; histopathology; perimenopausal.

scholarly journals Study of thyroid dysfunction in perimenopausal women with abnormal uterine bleeding

2019 ◽  
Vol 8 (6) ◽  
pp. 2519
Author(s):  
Velicheti Satya Sree ◽  
Gomathy E.
Keyword(s):  
Thyroid Dysfunction ◽  
Clinical Presentation ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Thyroid Function Tests ◽  
Appropriate Treatment ◽  
Perimenopausal Women ◽  
Thyroid Abnormalities

Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD.Methods: In the present study, Ninety patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients.Results: Among 90 patients, 22 patients were diagnosed as hypothyroidism and 9 as hyperthyroidism, women with AUB 59 (65.4%) were euthyroid. Among 31 women with thyroid abnormality, heavy menstrual bleeding was seen in 14 (45.1%) women, 11 (35.4%) had Polymenorrhagia, 6 (19.3%) had oligomenorrhea. The frequent menstrual abnormality in women with hypothyroidism (22 women) was heavy menstrual bleeding in 9 (40.9%) women, 5 (22.7%) had oligomenorrhea, 8 (36.3%) had Polymenorrhagia. Out of 9 women with hyperthyroidism, 3 (33.3%) had oligomenorrhoea, 4 (44.4%) had heavy menstrual bleeding, 2 (22.2%) had Polymenorrhagia.Conclusions: AUB might be because of structural or non-structural causes. Thyroid abnormalities may present in perimenopausal women with abnormal uterine bleeding, therefore proper identification of the cause of AUB is needed to give appropriate treatment to the patient. And to avoid unnecessary surgical intervention.

scholarly journals Abnormal Uterine Bleeding in Perimenopausal Age: Different causes and its relation with histopathology

2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Nazlima Nargis ◽  
Iqbal Karim ◽  
Khondaker Bulbul Sarwar
Keyword(s):  
Histopathological Examination ◽  
Medical Science ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Histopathological Findings ◽  
Medical College ◽  
Gynecology And Obstetrics ◽  
Study Results

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139

scholarly journals Histopathological pattern of endometrial samples in abnormal uterine bleeding

1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Physiological Changes ◽  
Biopsy Material ◽  
Histological Pattern ◽  
Biopsy Specimens ◽  
Histological Characteristics

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16

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 Addressing adenomyosis: Implications beyond we actually know

2019 ◽  
Vol 8 (9) ◽  
pp. 3644
Author(s):  
Ganesh Kumar ◽  
Purnima Pachori
Keyword(s):  
Recurrent Pregnancy Loss ◽  
Imaging Techniques ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Adherent Placenta ◽  
Clinical Presentations ◽  
Number Of Patients ◽  
Retrospective Comparative Study ◽  
Clinical Records

Background: Hysterectomy is one of the commonest gynecological surgeries being performed in India for various pelvic pathologies like fibroid uterus, endometrial hyperplasia, dysfunctional uterine bleeding, etc. But pre-operative diagnosis of adenomyosis and making it an indication for hysterectomy is not as common as pathologists find it in histo-pathology of hysterectomized specimens. The aim of the study was to study the frequency of adenomyosis in comparison to leiomyoma as a uterine pathology in hysterectomized specimens and correlate them clinically.Methods: A retrospective comparative study was carried out on 1646 hysterectomy specimens, during January 2014 to December 2016, which showed either adenomyosis or leiomyoma or both. Clinical records of these cases were retrieved and histo-pathology was correlated to clinical presentations and pre-operative ultrasonography.Results: Of the 1646 specimens taken for comparision between adenomyosis and leiomyoma, 49% showed only adenomyosis, 37% only leiomyoma and 14% had dual pathology showing findings of both. The peri-menopausal age group (45-54 years) accounted for the maximum number of patients undergoing hysterectomy (37.12%). But adenomyosis was found maximum in 35 - 44 years age group (38.04%). The clinical presentations for these two pathologies were similar and maximum patients presented with abnormal uterine bleeding and pelvic pain. Ultrasonography was able to diagnose only 32% cases of adenomyosis pre-operatively whereas this figure was 87% for fibroids.Conclusions: Adenomyosis and leiomyoma both account for the most frequent findings in hysterectomy specimens. Fibroids are easily diagnosed pre-operatively, but adenomyosis needs to be diagnosed pre-operatively by high index of clinical suspicion and imaging techniques. Adenomyosis is not just a disease of middle age, it needs to be addressed for infertility, recurrent pregnancy loss (RPL), bad obstetric history, IVF failures and adherent placenta as well.

scholarly journals Perdarahan uterus abnormal - menoragia pada masa remaja

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
John J. E. Wantania
Keyword(s):  
Human Growth ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Acute Bleeding ◽  
Menstrual Cycles ◽  
Human Growth And Development ◽  
Age Of Menarche

Abstract: WHO identifies adolescence as a period in human growth and development that occurs after childhood and before adulthood from age 10 to 19 years. Two large studies have shown that a greater increase in BMI in childhood is associated with earlier onset of puberty. In general, the age of menarche ranges relatively stable from 11 to 14 years with a median of 12.43 years. The average of menstrual cycle interval is 32.3 days in the first reproduction year. After that, the interval of menstrual cycles generally ranges from 21 to 45 days. Duration of menstruation is 7 days or less. The use of tampons or pads are generally three to six pieces per day. Abnormal uterine bleeding (AUB) is defined as a significant change in the pattern of menstruation or the volume of blood discharge, and is the most common complaint in women. In early adolescence, 75% of adolescents experience abnormal uterine bleeding. Heavy menstrual bleeding (HMB) as well as heavy and prolonged menstrual bleeding (HPMB) is the preferred term for excessive menstrual bleeding. Medical treatment is performed as the initial treatment as long as there is no contraindication. When the acute bleeding has been handled, it is recommended to arrange a transition in the long-term treatmentKeywords: menstruation, teens, abnormal uterine bleeding (AUB)Abstrak: WHO mengidentifikasi remaja sebagai periode pada pertumbuhan manusia dan perkembangan yang terjadi setelah masa kanak-kanak dan sebelum dewasa, dari umur 10 sampai 19 tahun. Dua studi besar telah membuktikan bahwa peningkatan IMT yang lebih besar pada masa kanak-kanak berhubungan dengan onset pubertas yang lebih awal. Usia menarche umumnya relatif stabil berkisar antara 11 dan 14 tahun dengan median 12,43 tahun. Interval siklus rata-rata ialah 32,3 hari pada tahun reproduksi pertama dan interval siklus mentruasi umumnya 21-45 hari. Lama menstruasi ialah 7 hari atau kurang. Penggunaan tampon atau pembalut umumnya tiga sampai enam buah per hari. Perdarahan uterus abnormal (PUA) adalah perubahan signifikan pada pola atau volume darah menstruasi dan merupakan hal yang paling banyak dikeluhkan oleh wanita. Pada awal usia remaja, 75% remaja mengalami keluhan PUA. Perdarahan haid berat (heavy menstrual bleeding) dan perdarahan haid berat dan memanjang (heavy and prolonged menstrual bleeding) ialah istilah yang lebih sering digunakan untuk perdarahan haid yang berlebihan. Penanganan medis menjadi terapi awal bila tidak ada kontrindikasi. Bila perdarahan akut sudah ditangani, direkomendasikan untuk melakukan transisi pada penanganan jangka panjang.Kata kunci: menstruasi, remaja, perdarahan uterus abnormal (PUA)

Abnormal menses and bleeding

2016 ◽  
Author(s):  
Stergios K. Doumouchtsis ◽  
S. Arulkumaran ◽  
Tahir Mahmood
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Physiological Basis

This chapter discusses abnormal menses and bleeding. It explores the physiological basis of menstrual bleeding, and the causes, investigations, and management of abnormal uterine bleeding, heavy menstrual bleeding (HMB), and dysmenorrhoea (period pains).

scholarly journals A study of gynecological profile of patients undergoing hysterectomy with special reference to its indications

2017 ◽  
Vol 6 (8) ◽  
pp. 3651
Author(s):  
Pujitha Devi Suraneni ◽  
Sradhanjali Maharana
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Medical Sciences ◽  
Detailed History ◽  
Common Indication ◽  
Common Complaint ◽  
Gynecological Examination ◽  
Number Of Patients ◽  
The World

Background: Hysterectomy is the most frequently performed major gynecological surgical procedure, with millions of procedures performed annually throughout the world. Approximately 90% of hysterectomies are performed for benign conditions, such as fibroids causing abnormal uterine bleeding. Objective of the study was to study the gynecological profile of women undergoing hysterectomy.Methods: In this study 60 cases of hysterectomy were analyzed over a period of 2 years who underwent hysterectomy at Department of Obstetrics and Gynecology, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar. Informed consent was taken from all women. Detailed history, complete clinical, gynecological examination was carried out.Results: Maximum patients i.e. 56.7% were in the age group of 41-50 years followed by the age of 31-40 years i.e. 33.3%. Maximum number of hysterectomies were performed in Para 3. Maximum number of patients had menstrual problems which are about 63.3% and next more common complaint was discharge per vagina (53.3%). Of the 60 cases that underwent hysterectomies 40% of them are for abnormal uterine bleeding, 30% of them are for uterine fibroid, 15% of them are for endometriosis, 8.3% of them are for adenomyosis, 6.6% of them are for cervical dysplasia.Conclusions: The most common indication for hysterectomy was abnormal uterine bleeding.

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