scholarly journals Study on abnormal uterine bleeding among adult women in a tertiary care hospital in Bihar, India

Author(s):  
Kajal Sinha ◽  
Prajnanika Gurung ◽  
Hemali H. Sinha ◽  
Punam P. Bhadani

Background: Abnormal uterine bleeding (AUB) is the most common problem among patients coming to gynaecology outpatient department. There are various pathologies which can lead to AUB. History, blood investigations, ultrasonography, hysteroscopy and endometrial aspiration are the methods to rule out different causes. Later on, they are classified as per PALM-COEIN classification. It helps in better and successful management of AUB patients.Methods: It was a retrospective study done in Obstetrics and Gynaecology Department of AIIMS Patna from March 2014 to March 2016. A total of 272 cases were selected and data were collected in structured proforma on excel sheet.Results: The most common age-group presenting with AUB was 40 to 49 years of age (58%) and the most common histological pattern was secretory (47.7%).  Menorrhagia was found to be the most common problem in AUB patients (58.45%). As per PALM- COEIN classification, the most common type in our study was found to be AUB-E (26.8%). In a sub-set of patients, who underwent hysterectomy, histopathological samples were compared to endometrial samples which were similar in 81.6% cases.Conclusions: Incidence and pattern of AUB varies according to the age of the patient. It is more common in perimenopausal age-group. Classification of AUB as per PALM-COEIN helps in better understanding of disease and successful management of patients. 

2021 ◽  
Vol 6 (3) ◽  
pp. 187-190
Author(s):  
Tina Rai ◽  
Upasana Uniya ◽  
Archana Shrivastava ◽  
G.S Rai

: Abnormal uterine bleeding is a common clinical presentation in the perimenopausal age group its biopsy serves as an excellent clue to the underlying disease. The presentation may vary according to the type of endometrial hyperplasia and their correlation helps in the proper management of the patients complain.: To analyze the histopathological patterns of endometrial hyperplasia as well as to correlate endometrial hyperplasia with the clinical parameters.: It is a retrospective study and included one year data. A total of 125 cases that underwent hysterectomies or endometrial biopsies for abnormal uterine bleeding were recorded with their clinical history. For all cases the histopathology slides were re-evaluated and results were recorded. Epidemiological variables were analyzed by cross tabulation to assess their relationship. Out of 125 cases 53 cases had endometrial hyperplasia, 24 cases were having simple hyperplasia followed by 14 cases with simple hyperplasia without atypia, 9 cases with complex hyperplasia with atypia followed by 6 cases with complex hyperplasia without atypia. 30 to 50 years age group commonly had endometrial hyperplasia & menorrhagia was the common clinical complain in our patients.: In all the females coming to OPD with abnormal uterine bleeding clinical correlation should be properly made with biopsy report of the patient for the proper management of the condition, which avoids landing up of the patient into further complication.


2021 ◽  
pp. 30-33
Author(s):  
Bhakti D Deshmukh ◽  
Anuradha Malpani ◽  
Alka V Gosavi ◽  
Kalpana R Sulhyan ◽  
Rucha M Pimpalkhute

BACKGROUND –Abnormal uterine bleeding (AUB) is dened as a bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle. The term dysfunctional uterine bleeding (DUB) is used to describe abnormal uterine bleeding for which no specic cause has been found. AUB is one of the most common gynaecological problems. This study was done to evaluate histological patterns of endometrium in women with abnormal uterine bleeding. AIMS AND OBJECTIVE – To study various histological patterns of endometrium in abnormal uterine bleeding and correlate it with age, parity and symptoms. MATERIAL AND METHODS –This is a retrospective study, conducted in the Department of Pathology, in a tertiary care hospital from 1st July 2016 to 30th June 2019. Total 718 specimens with AUB were included in the study from the age group of 21 to 95 years. The specimens received were hysterectomy (74.65 %), endometrial biopsies (21.45%), dilatation and curettage (2.79 %) and transcervical resection of endometrium (1.11 %). RESULTS –The patients with AUB were mainly from the age group 41-50 years with menorrhagia as the chief complaint. Most of the women with AUB were multiparous (84.54%). The most common pattern observed on histopathological examination was proliferative endometrium (49.86%) followed by atrophic endometrium (10.31%). Malignancy was found in 2.23% (Endometrioid carcinoma – 1.81%, serous carcinoma - 0.14% and mucinous carcinoma – 0.28%). Endometrial hyperplasia without atypia (23 cases, 3.20%) was more common than endometrial atypical hyperplasia (EAH) / endometrioid intraepithelial neoplasia {EIN} (4 cases, 0.56 %). Various other patterns of endometrium on histopathology were endometritis (6.82 %) followed by endometrial polyp (4.46 %). CONCLUSION – Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.


2021 ◽  
Vol 12 (9) ◽  
pp. 84-87
Author(s):  
Nabanita Chakraborty ◽  
Rajasri Chunder ◽  
Barnali Mukherjee ◽  
Soham Chakraborty

Background: Menopause is an important event in women’s life and it marks the end of a woman`s reproductive life. Perimenopause is the interval in which a woman`s body makes a natural shift from regular cycles of ovulation & menstruation to irregular cycles and various forms of abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is a very frequent complaint from women in the perimenopausal age group. The histological diagnosis of DUB and its proper management is very essential in this age group. Aims and Objective: Primary aim of our study was to identify the spectrum of histological changes that occur in the endometrium in perimenopausal age group and to identify the demographic pattern of each histological change. Materials and Methods: Fifty-two specimens of endometrial biopsy obtained from the patients in the perimenopausal age group of 40-50 years attending the Gynaecology and Obstetrics department were studied. Results: 71.15% cases of DUB was diagnosed amongst the 52 endometrial biopsy specimens in perimenopausal age group and Secretory endometrium is most common histological pattern. Conclusion: This study reflects a spectrum of endometrial histology present during perimenopausal age. This study has  also highlighted the correlation of endometrial histology with final diagnoses of the patients, and this may help in diagnosis and treatment of gynaecological diseases of this specific age group in future.


Author(s):  
Dr. Yogesh C. Parmar

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of dysfunctional  uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders. Methods: A retrospective study of randomly selected 70 cases of dysfunctional  uterine bleeding admitted during October 2006 to September 2007, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. Only cases of AUB due to non-structural causes were included. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months. Results: Most common age group presenting with DUB was 40–50 years  and mostly  belonged to low socioeconomic status. Most of the women were multiparous.  Polymenorrhagia and menorrhagia was most common presentation. Size of uterus is normal in 44 patients. Dilatation and curratage was  having the cure rate of 65.6% .Maximum number of patients (85%) was treated surgically and 15% got medical treatment. Conclusions: Dysfuntional uterine bleeding (DUB) now termed as Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.   Keywords   Menorrhagia, Dysfunctional uterine bleeding,Abnormal uterine bleeding Perimenopausal women, Endometrium


Author(s):  
Harshdeep Jadeja ◽  
Komal Inani Jhanwar

Background: Abnormal uterine bleeding is one of the commonest cases seen in gynecology OPD in the country. The incidence is more commonly seen in late adolescence and perimenopausal group of patients. A fair and objective procedural pattern needs to be adopted to ensure that these patients undergo rapid diagnosis and treatment. The Palm-Coein system is considered as the gold standard. The present study aims to ascertain the efficacy of this system in AUB patient diagnosis.Methods: The study involved as sample of 120 subjects who came to the OPD of the institute and consented to be a part of the study. The subjects were examined and relevant data pertaining to their diagnosis and management was recorded. The data was analyzed and reported.Results: The data revealed that menorrhagia was the commonest complaint. The predominant age group was above 40 years, and had a normal radiological profile in most cases. The use of Palm-Coein system proved effective in determining the diagnosis as well setting a procedural mechanism for adequate management.Conclusions: Palm-Coein is an effective modality for diagnosing and managing AUB cases in a tertiary care set up and can be adopted as a standard practice.


Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karnaboopathy Ranganathan

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.


Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya

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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