scholarly journals Co-relation of endometrial thickness by transvaginal sonogram with histopathology pattern in abnormal uterine bleeding: a study from South India

2020 ◽  
Vol 9 (4) ◽  
pp. 1416
Author(s):  
Chippy Tess Mathew ◽  
Uma Maheswari ◽  
Karthikeyan Shanmugam
Keyword(s):  
Precancerous Lesions ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Sampling ◽  
Dilatation And Curettage ◽  
Number Of Patients ◽  
Fourth Decade ◽  
Proliferative Endometrium

Background: Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (around 80 ml). Bleeding that occurs erratically or excessive menstrual bleeding is called abnormal uterine bleeding (AUB). The causes of AUB are many and varied. Initial investigations include transvaginal ultrasound and histopathologic assessment of the endometrium. Objective of this study was to evaluation of endometrial thickness with trans-vaginal ultrasound and its correlation with histopathology by dilatation and curettage in abnormal uterine bleeding. To determine the efficacy of transvaginal ultrasound in evaluating the endometrial thickness. To correlate the endometrial thickness by transvaginal ultrasound with endometrial histopathology in women with AUB.Methods: It is a retrospective observational study. All reproductive and perimenopausal age group women who underwent dilatation and curettage for abnormal uterine bleeding during the period June 2014-June 2016 was taken and analyzed and correlated with their endometrial thickness measured with Transvaginal ultrasound.Results: Around 478 patients who underwent endometrial sampling over a period of two years were analyzed. Maximum number of patients were in the fourth decade and the overweight category 36.6%. Proliferative endometrium was the most common histopathologic picture (44.76%). Detection of precancerous lesions were-5.87% and endometrial cancer was 1.05%.Conclusions: An ET of 8 mm and above gave 100% sensitivity and negative predictive value for precancerous and cancerous lesions.

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

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 A prospective study on the efficacy of Pipelle biopsy to diagnose endometrial pathology in patients with abnormal uterine bleeding

2019 ◽  
Vol 8 (11) ◽  
pp. 4238
Author(s):  
Sunitha Mary Mathew ◽  
Pramod Thomas
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Focal Lesions ◽  
Endometrial Sampling ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.

scholarly journals Histopathological study of endometrium in abnormal uterine bleeding

2012 ◽  
Vol 2 (4) ◽  
pp. 297-300 ◽  
Author(s):  
S Bhatta ◽  
AK Sinha
Keyword(s):  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Histopathological Study ◽  
Endometrial Sampling ◽  
Proliferative Endometrium ◽  
Malignant Lesions ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).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.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

scholarly journals Abnormal Uterine Bleeding – A Clinico-pathological Study

2021 ◽  
Vol 8 (1) ◽  
pp. A9-13
Author(s):  
Sarita . ◽  
Nisha J Marla ◽  
Nagarathna . ◽  
Jayaprakash C S
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Reproductive Period ◽  
Uterine Bleeding ◽  
Target Organ ◽  
Direct Access ◽  
Age Group ◽  
Morphological Findings ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium

Background: Abnormal Uterine Bleeding (AUB) can occur at any age in a woman`s reproductive period and needs to be assessed very carefully and immediately. When it occurs in the older age group, a more meticulous screening for malignancy is imperative so that treatment can be more radical. Dilatation and curettage is a simple, cost effective, safe and a reliable investigation and it gives us a direct access to the target organ. Methods: Study was conducted prospectively on 162 patients presenting with AUB in reproductive, perimenopausal and postmenopausal age group. All the endometrial samples procured from the endometrial curettage were fixed in 10% buffered formalin for 12-24 hours, processed in the automated tissue processor, cut and stained with Hematoxylin & Eosin (H & E) stain and were finally studied in detail for the morphological findings under light microscopy. Result: In our study Secretory endometrium was most common type, which was followed by Proliferative endometrium. Disordered proliferative endometrium and Endometrial hyperplasia were the commonest histopathological patterns seen in AUB of organic type. Endometrial carcinoma was seen more commonly in postmenopausal age group. Further, in our study Mc Cluggage criteria was applied to all the samples to categorize endometrial samples which were unassessable and inadequate. Conclusion: Evaluation of Endometrial samples is important in all patients with Abnormal Uterine Bleeding (AUB) to find out the Organic Pathology. Histopathological typing of endometrium is crucial for appropriate therapy. Its interpretation is quite challenging and also may show considerable interobserver variability. In AUB, the endometrial samples should be taken during the bleeding episode itself. Dilatation and curettage is a simple, cost effective, safe and reliable investigation and gives us a direct access to the target organ.

scholarly journals Endometrial study by Ultrasonography and its correlation with Histopathology in Abnormal uterine bleeding

2018 ◽  
Vol 9 (2) ◽  
pp. 31-35
Author(s):  
Pravin Shrestha ◽  
Smita Shrestha ◽  
Vibha Mahato
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Proliferative Endometrium ◽  
Group 2 ◽  
Histopathological Workup

Background: Abnormal Uterine Bleeding is defined as any deviation from a normal menstrual pattern. It is one of the common presentation in extremes of ages. However endometrial hyperplasia and carcinoma are commoner in perimenopausal and postmenopausal women warranting investigations like ultrasonography and endometrial biopsy.Aims and Objective: The aim of the study was to note the endometrial thickness by transabdominal ultrasonography and observe the histopathological pattern in women presenting with abnormal Uterine Bleeding.Material and Methods: Premenopausal women more than 45 years of age and the postmenopausal patients, without any pelvic pathology were included in the study. Endometrial thickness was measured by transabdominal sonography and endometrial biopsy was done. Tissue obtained was sent for histopathological examination.Results: A total of 105 patients were studied. Majority (92%) of patients were premenopausal. Proliferative Endometrium (32%) was the most common finding in premenopausal and atrophic endometrium (37.5%) in postmenopausal group. Malignancy was higher in a postmenopausal group (12.5%) as compared to the premenopausal group (2%). Malignancy was not seen when endometrial thickness was less than 11mm in the premenopausal age group. Endometrial hyperplasia was also more common when the thickness was more than 11mm.In postmenopausal group12.5% of patients, had complex hyperplasia.25% had simple hyperplasia and malignancy was seen in 12.5% of patients. When endometrial thickness was less than 5 mm, hyperplasia and malignancy was not seen.Conclusion: Measurement of Endometrial thickness and histopathological workup in patients above 45 years presenting with abnormal uterine bleeding will be helpful in detecting endometrial hyperplasia and carcinoma.Asian Journal of Medical Sciences Vol.9(2) 2018 31-35

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