scholarly journals Correlation between ultrasonographic, hysteroscopic and histopathological findings in patients with abnormal uterine bleeding

2018 ◽  
Vol 7 (8) ◽  
pp. 3250
Author(s):  
Binti R. Bhatiyani ◽  
Shrikant Dhumale ◽  
Pandeeswari . ◽  
Dolly Bashani
Keyword(s):  
Endometrial Thickness ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Complete Evaluation ◽  
Medical Visits ◽  
Adnexal Pathology ◽  
Rule Out

Background: Menstrual disorders are common indication for medical visits among women of reproductive age and heavy menstrual bleeding affects up to 30% of women throughout their reproductive lifetime. This study aims at evaluating the different causes and, the clinical presentation of AUB and to compare the role of hysteroscopy, ultrasonography and histopathology in patients with AUB.Methods: 100 women above 45 years of age, presenting with abnormal bleeding per vaginum were evaluated. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium using a curette. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated.Results: Incidence of AUB was present between the age groups of 45-49 years of age (66%). The commonest presenting complaint in this series was menorrhagia or heavy menstrual bleeding (60%). The finding of thickened endometrium as the most common abnormality on USG (44%) and also on hysteroscopy (45%). As per present study the sensitivity of hysteroscopy is 97.78% and specificity was 34.55%, the negative predictive value of the test is 95%.Conclusions: TVS may be the first line of investigation while evaluating the endometrium in a perimenopausal AUB. It helps to triage the patients into high risk or low risk. Endometrial thickness >4mm as per the present study needs further evaluation. Patients with endometrial thickness less than 4 mm can be reassured. Hysteroscopy is the gold standard in the diagnosis of focal pathology like sub mucous fibroid, polyps or anomalies. Histopathology probably is an indispensable tool specially to rule out premalignant and malignant conditions. Thus, all the modalities instead of being competitive to one another, are complimentary to each other. For complete evaluation of patient with AUB all the three modalities should be used together to come at exact diagnosis.

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 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 Ormeloxifene in acute heavy menstrual bleeding in menopausal transition

2021 ◽  
Vol 12 (8) ◽  
pp. 88-93
Author(s):  
Subha Shrestha ◽  
Babita Thapa ◽  
Sebina Baniya ◽  
Vivek Pandey
Keyword(s):  
Medical Therapy ◽  
Transition Period ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menopausal Transition ◽  
Menstrual Bleeding ◽  
Common Side Effect ◽  
Subjective Improvement

Background: Ormeloxifene, a selective estrogen receptor modulator, is a safer, cost effective and convenient dosing medical therapy in heavy menstrual bleeding of acute abnormal uterine bleeding. Aims and Objective: The study aimed to find the effectiveness of Ormeloxifene as 1st line therapy for heavy menstrual bleeding in menopausal transition women to prevent unnecessary hysterectomies and improve quality of life. Materials and Methods: This descriptive study was conducted at Lumbini Medical College for a period of one year. Sixty-five cases of acute Abnormal Uterine Bleeding with heavy menstruation during menopausal transition period were provided with Ormeloxifene therapy of 60 milligrams dose two times per week after evaluating pre treatment hemoglobin percentage, Pictorial Blood Loss Assessment Chart (PBAC) score and endometrial thickness. The dose of the drug was reduced to 60 mg weekly after 3rd month if subjective improvement was documented and continued for further 3 months. Results: There was a statistically significant reduction in mean PBAC score, mean endometrial thickness and rise in hemoglobin level. Eighty percentages of women had marked subjective improvement of symptoms, 87.7% women had reduction of blood clots, 15. 8% women had relief from dysmenorrheal pain and 50.8% women had regularization of menstrual pattern after 6 months. Amenorrhea (25.3%) was the most common side effect reported in 6 months therapy. Conclusion: Ormeloxifene is an effective 1st line medical therapy in acute heavy menstrual bleeding in menopausal transition women.

scholarly journals Clinical profile of 500 cases of Polycystic Ovary Syndrome in a Tertiary Hospital

2020 ◽  
Vol 33 (1) ◽  
pp. 45-48
Author(s):  
Nusrat Mahjabeen ◽  
Sk Zinnat Ara Nasreen ◽  
Faryl Mustary
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Abnormal Uterine Bleeding ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Menstrual Disturbances

Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to18% of women. It has been suggested that this condition occurs in as many as 4-10% ofwomen of reproductive age. PCOS is associated with significant reproductive morbidity,including infertility, abnormal uterine bleeding, miscarriage and other complications ofpregnancy. Method: This cross-sectional study was carried out in the Department of Obstetrics andGynaecology of Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January,2013 to December, 2016 over a period of 4 years with the objective to find out various clinicalpresentations, endocrine status, the menstrual abnormalities and sonographic findings ofthe patients with PCOS. During the study period a total number of 1600 patients wereexamined for infertility in the Outpatient and in Inpatient Department. Out of these 1600infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailedinformation about the patients were collected in a predesigned data collection sheet. Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%)had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration ofinfertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in78.0 percent of PCOS patients, of which & 90 (18.0%) had amenorrhoea, 250 (50.0%) hadoligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normalmenstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normalBMI and 60 (12.0%) were under weight. Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients.Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalenceof menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% hadamenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 45-48

scholarly journals Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses

2019 ◽  
Vol 9 (1) ◽  
pp. 283
Author(s):  
Vinita Sarbhai ◽  
Medha Yadav
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Ovarian Cyst ◽  
Imaging Modality ◽  
Age Groups ◽  
Serous Cystadenoma ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Adnexal Pathology ◽  
Rule Out

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.

scholarly journals Current trends in the pharmacotherapy of uterine myoma, associated with heavy menstrual bleeding and anemia: review

2020 ◽  
Author(s):  
Z. V. Revazova ◽  
L. V. Adamyan ◽  
O. N. Loginova ◽  
L. M. Manukyan ◽  
K. N. Arslanyan
Keyword(s):  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Cochrane Library ◽  
Pharmacological Agents ◽  
Surgical Interventions ◽  
Current Trends

Aim: to summarize results of up-to-date world researches on the current trends of symptomatic myoma treatment.Materials and Мethods. A search of publications was carried out in the main international databases in Russian and English languages: PubMed/MEDLINE, The Cochrane Library, Embase, eLibrary. The analysis included studies published over the past 10 years examining the clinical efficacy and safety of various groups of pharmacological agents for the treatment of uterine myoma combined with heavy menstrual bleeding in women of reproductive age.Results. Currently, the treatment of uterine fibroids is divided into three main methods: surgical, minimally invasive organ-preserving methods, and pharmacotherapy. Until now, surgical intervention remains the main method of treatment, and, unfortunately, is often carried out in the volume of hysterectomy. However, today it is important to have a personalized approach to the management of a patient with symptomatic uterine myoma, taking into account her desire to preserve reproductive function. The development of the possibilities of drug therapy made a great contribution to the optimization of managing such patients.Conclusion. The global trend is to decrease the number of radical interventions, as well as the development and improvement of new methods of treating symptomatic uterine fibroids. Currently, pharmacotherapy of leiomyoma can significantly improve the quality of life of patients, reduce radical surgical interventions, optimize surgical treatment, and in certain situations, completely eliminate the need for surgery.

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).

COMPARATIVE STUDY OF ENDOMETRIAL CYTOLOGY AND ENDOMETRIAL BIOPSY IN PERI MENOPAUSAL WOMEN

2021 ◽  
pp. 42-43
Author(s):  
Vasudha Rani ◽  
Punam Kumari ◽  
Asha Jha
Keyword(s):  
Endometrial Cancer ◽  
Minimally Invasive ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Focal Lesion ◽  
Diagnostic Strategy ◽  
Rule Out

Abnormal Uterine Bleeding (AUB) is one of the most common health problems encountered by women. It affects about 20% women of reproductive age, and accounts for almost two thirds of all hysterectomies. Gynaecologists are often unable to identify the cause of abnormal bleeding even after a thorough history and physical examination. Diagnostic evaluations and treatment modalities have been evolving over time. The onus in AUB management is to exclude complex endometrial hyperplasia and endometrial cancer. From D and C + EUA under general anaesthesia the shift to more accurate procedures like hysteroscopy and vision directed biopsy was welcome. But the current minimally invasive procedures like sonohysterography, ofce vacuum aspiration (Pipette) and the use of ofce hysteroscopy have revolutionized the management of AUB. We have tried to review the current literature and guidelines for evaluation of endometrium with the twin goals of nding an accurate reason causing the AUB and to rule out endometrial cancer or a potential for the cancer in future. We have also attempted to compare the current procedures and their present perspective vis-à-vis each other. Histological assessment is the nal word, but obtaining a sample for histology makes it more accurate, and we have reviewed these techniques to enhance accuracy in diagnosis. Hysteroscopy and directed biopsy is the 'gold standard' approach for most accurate evaluation of endometrium to rule out focal endometrial Carcinoma. Blind endometrial biopsies should no longer be performed as the sole diagnostic strategy in perimenopausal as well as in postmenopausal women with AUB. Asingle-stop approach, especially in high risk women (Obesity, diabetes, family history of endometrial, ovarian or breast cancer) as well as in women with endometrial hyperplasia of combining the ofce hysteroscopy, directed biopsy in presence of a focal lesion, and vacuum sampling of endometrium in normal looking endometrium, all without anesthesia is the most minimally invasive and yet accurate approach in current practice.

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