scholarly journals Sonographic and histopathological correlation and evaluation of causes of abnormal uterine bleeding in perimenopausal women

2019 ◽  
Vol 8 (10) ◽  
pp. 3920
Author(s):  
Garima Kumari ◽  
Kuldeep Poonia
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
First Line ◽  
Histopathological Correlation ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
A Prospective Study

Background: Perimenopausal period in a woman’s lifetime marks a transition from reproductive phase to that of menopause. Abnormal uterine bleeding (AUB) is a common problem among women in the reproductive age.Methods: It was a prospective study on 100 perimenopausal women in age group 39-51 years with abnormal uterine bleeding who underwent Hysterectomy at SMS Hospital, Jaipur. At the end clinical diagnosis, ultrasonographic findings and histopathological reports were correlated.Results: 42.0% cases had HMB menstrual pattern followed by 24.0% cases had HPMB and 18.0% of the cases had PB. Intermenstrual bleeding was seen in 2% cases.  In clinical finding, 71.0% cases had fibroid followed by 15.0% cases had adenomyosis and 6.0% of the cases had fibroid+adenomyosis. The clinical diagnosis was confirmed by ultrasonography. Ultrasound detected fibroid in 95.8% of the cases who were suspected to have fibroid on clinical examination. Out of the 15 patients who were clinically suspected to have adenomyosis, 53.3% confirmed on ultrasound, ultimate diagnosis was made on the basis of histology, so every hysterectomy specimen was sent for histopathological examination. Out of the 68 patients who were diagnosed to have fibroid uterus on ultrsonography, 66 patients were confirmed to have fibroid. Out of the 8 patients who were labelled as adenomyosis after ultrasound, 4 patients were diagnosed to have adenomyosis on histopathology and in rest 4 patients, no gross pathology was detected.Conclusions: A transvaginal ultrasound should be offered as the first line of imaging. Clinical, radiological and pathological evaluation correlated well to diagnose fibroids, however clinically as well as USG proved to be of little help in diagnosing adenomyosis.

A STUDY OF CLINICAL CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING AT JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 73-74
Author(s):  
Archana Jha ◽  
Satyendra Kumar ◽  
[Prof.] Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Clinical Impression ◽  
Histopathological Diagnosis ◽  
Endometrial Sampling ◽  
Carcinoma Of Cervix ◽  
Perimenopausal Women ◽  
Pathological Evaluation

Background: Abnormal uterine bleeding in perimenopausal women accounts for about 70% of gynaecologic Outpatient Department visits. Perimenoppause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more or less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Polymenorrhagia, intermenstrrual bleeding and metrorrhagia are other common disorders at perimenopause. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding after ruling out medical causes. The present study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with clinical diagnosis and histopathological examinations. A total of 150 perimenopausal Material and Methods: women with abnormal uterine bleeding in the age group of 37-51 years for a period of 6 months were included. These women were evaluated clinically and ultrasonographically for the cause of abnormal uterine bleeding. Clinical impression and USG reports were correlated. These women underwent dilatation and curettage for endometrial sampling and specimen sent for histopathological examination. Histopathological reports were correlated with clinical diagnosis. Most of the patients with AUB were Results: between 37-41 years of age (56%). The incidence was high in parity-3 (26%) annd grand multipara (49.33%). The majority of the women were presented with menorrhagia (54.66%). Clinically, majority of the cases were diagnosed as broids 66 (44%) followed by dysfunctional uterine bleeding (DUB) 56 (37.33%). However, histopathological reports conrmed broid in 52 cases, DUB in 49, adenomyosis in 36 and polyp in 11 cases. Fibroi Discussion: ds are common nding in women with menorrhagia. Clinical, radiological and pathological evaluation correlated very well to diagnose broids and DUB. However clinically as well USG proved of little help to diagnose adenomyosis and carcinoma of cervix and endometrium. Thus, histopathological evaluation of endometrium is recommended in perimenopausal women.

scholarly journals A descriptive study of Endometrial Biopsies in perimenopausal women having Abnormal uterine bleeding

2021 ◽  
Vol 6 (3) ◽  
pp. 203-205
Author(s):  
Sandhya I ◽  
Manjushree Prabhu P ◽  
Purnima S Rao ◽  
Sameeksha Alwa
Keyword(s):  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
Secretory Endometrium

Abnormal uterine bleeding (AUB) is one of the commonest symptom with which the perimenopausal female visits the gynaecologist accounting for over 70% of all gynecological consultations in that age group. The clinical presentation of AUB can range anywhere menorrhagia, polymenorrhea, polymenorrhagia, metrorrhagia, and menometrorrhagia. Though biopsy is the gold standard it is an invasive procedure and hence often an Ultrasound is used to evaluate the pathology of the endometrium routinely hence, we decided to study the accuracy between radiological ET thickened and its usefulness in detecting endometrial pathology. This study was carried out in the Department of Pathology at AJIMS, Mangalore for a period of 2 years. The sample included endometrial biopies and hysterectomy specimens of perimenopausal women for AUB. The ultrasonographic findings and Histopathological (HPE) reports were analysed. Among 101 cases for AUB, 67 cases were diagnosed as non secretory endometrium. Out of these 67 cases, 49 cases were associated with fibroids. Out of the rest of the AUB cases, 31 of them were diagnosed to have endometrial hyperplasia and 3 cases were diagnosed to have endometrial carcinoma. USG thickness of 17(54%) out of 31 endometrial hyperplasia cases were abnormal. Radiological and pathological evaluation were concordant with diagnosis of AUB associated with fibroids. However only 54% of the endometrial hyperplasia were found to have abnormal endometrial thickness. Radiological evaluation of endometrial thickness is not concordant in 46 % of the cases. This implies that histopathological examination is gold standard diagnostic tool for endometrial abnormalities in perimenopausal women.

scholarly journals Clinico-histopathological and ultrasonographic correlation of abnormal uterine bleeding in perimenopausal and postmenopausal women

2021 ◽  
Vol 10 (6) ◽  
pp. 2408
Author(s):  
Sharanya . ◽  
Julie Thomas
Keyword(s):  
Data Entry ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Ethical Review ◽  
Histopathological Correlation ◽  
Endometrial Pattern ◽  
Endometrial Hyperplasia With Atypia ◽  
Observational Group ◽  
A Prospective Study

Background: Abnormal uterine bleeding (AUB) accounts for one of the most common gynaecological problem, almost one third of total cases. The study was a prospective study done from December 2017 to November 2019. The histopathological reports of endometrial pattern as well as that of hysterectomy specimens were correlated with clinical diagnosis and ultrasonographic findings. The main objective was to study the correlation between clinical, ultrasonographic and histopathological correlation of AUB in perimenopausal, menopausal and postmenopausal women.Methods: Formal Permission was obtained from the administrator of St. Philomena’s hospital. Ethical clearance was obtained from institutional ethical review board of St. Philomena’s hospital. Informed consent was obtained from observational group and confidentiality was assured.  Data entry and analyses was done using the Statistical Package for Social Sciences (SPSS) for Windows software (version 20.0; SPSS Inc, Chicago).Results: A total number of 165 cases were studied. Maximum women were in the age group of 40-55 years 87.27%. Most common presentation of abnormal uterine bleeding is menorrhagia which accounts for 72.7% of women (120 women). The most common finding noted in USG was fibroid uterus which accounts for 44.2% of women (73 women). Most commonly observed histological pattern noted were proliferative (62.4%) followed by secretory endometrium (8.5%) and simple endometrial hyperplasia with atypia (8.5%).Conclusions: In conclusion, AUB is one of the most common condition for which patients seek advice in the gynaecological outpatient department. Analysis of histopathology of endometrium in abnormal uterine bleeding helps in management of patients and to know the pathological incidence of structural causes in AUB prior to surgery.

scholarly journals A clinical study of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation

2018 ◽  
Vol 7 (2) ◽  
pp. 396
Author(s):  
Shanmugapriya Kumaresan ◽  
Devika Perumal
Keyword(s):  
Tamil Nadu ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Clinical Problem ◽  
Uterine Bleeding ◽  
College Hospital ◽  
Histopathological Correlation ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity ◽  
A Prospective Study

Background: Abnormal uterine bleeding is a common clinical problem with myriad of causes. The diagnosis and management of abnormal menstrual function must be based on an understanding of the physiologic mechanisms involved in the regulation of the normal cycles. Diagnostic hysteroscopy is a valuable tool in diagnosing structural intra-cavital pathology, very suitable for out-patient clinic.Methods: This is a prospective study which has been carried out in the Department of Obstetrics and Gynecology, Tirunelveli medical college hospital, Tirunelveli, Tamil Nadu from January 2011 to October 2011.Results: A total of 50 cases were analysed among the 50 patients tested. 26 patients had some pathology of which 24were accurately detected by hysteroscopy, missed 2 cases of irregular shedding endometrium which was reported by histopathology.Conclusions: Hysteroscopy is a safe, reliable and quick procedure in the diagnosis of cases with abnormal uterine bleeding with high sensitivity, specificity and negative predictive value.

scholarly journals Study of endometrial histopathology in women with abnormal uterine bleeding

2017 ◽  
Vol 6 (3) ◽  
pp. 824
Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karnaboopathy Ranganathan
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
A Prospective Study ◽  
Secretory Endometrium

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.

scholarly journals Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy

2014 ◽  
Vol 12 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Marco Antonio Lenci ◽  
Vanessa Alessandra Lui do Nascimento ◽  
Ana Beatriz Grandini ◽  
Walid Makin Fahmy ◽  
Daniella de Batista Depes ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Premalignant Lesions ◽  
Endometrial Polyps ◽  
Menstrual Status ◽  
Cellular Atypia ◽  
Malignant Lesions

Objective : To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy. Methods : The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.9%) patients were in menacme. Of the total, 193 (65.4%) presented abnormal uterine bleeding, and 102 (34.6%) were asymptomatic with altered endometrial echo on transvaginal ultrasound. Out of 725 (71.1%) postmenopausal patients, 171 (23.6%) were symptomatic (abnormal uterine bleeding), and 554 (76.4%) were asymptomatic with endometrial echo >5.0mm. Results : Twenty-one (2.0%) patients presented premalignant lesions in the polyps, 13 had simple glandular hyperplasia, of which 5 had no atypia, and eight presented atypia. Eight polyps presented focal area of complex hyperplasia: 4 with atypia and 4 without lesions. Cancer was diagnosed in 5 (0.5%) polyps. Of the 21 polyps that harbored premalignant lesions, 12 were interpreted as benign in diagnostic and surgical hysteroscopy. Of the polyps with cancer, 4 were also histeroscopically interpreted as normal. Conclusion : Symptomatic polyps in menacme and in all postmenopausal women should be resected and submitted to histopathological examination, since they may have a benign aspect, even when harboring areas of cellular atypia or cancer.

scholarly journals A prospective study of comparison between transvaginal sonogram and histopathological examination in perimenopausal women with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4233
Author(s):  
P. Rishma Priyanka ◽  
C. Rama Mani ◽  
A. Yamuna
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Main Concern ◽  
Dilatation And Curettage ◽  
Perimenopausal Women ◽  
Histopathological Report

Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.

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