scholarly journals Abnormal uterine bleeding: study among patients in a tertiary hospital in Southern Rajasthan

2021 ◽  
Vol 10 (6) ◽  
pp. 2264
Author(s):  
Harshdeep Jadeja ◽  
Komal Inani Jhanwar
Keyword(s):  
Gold Standard ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Tertiary Hospital ◽  
Rapid Diagnosis ◽  
Uterine Bleeding ◽  
Age Group ◽  
Standard Practice ◽  
Diagnosis And Management ◽  
Set Up

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.

scholarly journals Transvaginal Ultrasonography and Hysteroscopy in Evaluation of Abnormal Uterine Bleeding- A Cross-sectional Study

2021 ◽  
Author(s):  
G Sindhujha Sekar ◽  
A Esther Ruby ◽  
P Lalitha
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional

Introduction: In perimenopausal age group particularly, 70% of all gynaecological consultations are for Abnormal Uterine Bleeding (AUB). About 30% of women seek medical assistance for AUB during their reproductive age group and about one third of hysterectomies are carried out for AUB alone. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of Transvaginal Ultrasonography (TVS) versus hysteroscopy in detecting uterine abnormalities Materials and Methods: A cross-sectional study in patients with AUB, admitted to the Department of Obstetrics and Gynaecology at RGGWCH, Puducherry between February 2016 and February 2017 who met the inclusion criteria were included. Sample size was 85 cases. After taking detailed history and physical examination the patient was investigated to rule out organic causes of AUB and then TVS and hysteroscopy were done. Any intrauterine pathology was looked for and endometrial sampling was taken from the abnormal sites for Histopathological Examination (HPE). Both TVS and hysteroscopy results were compared with histopathology which is the gold standard. Results: The sensitivity of TVS in diagnosis of uterine fibroid in comparison to hysteroscopy was 94.74% and the specificity was 71.21%. The sensitivity of hysteroscopy in diagnosis of endometrial hyperplasia in comparison to HPE was 75% and the specificity was 87.01%. The sensitivity of TVS in diagnosis of endometrial hyperplasia in comparison to HPE was 37.5% and the specificity was 90.91%. The sensitivity of hysteroscopy in diagnosis of polyp in comparison to HPE was 100% and the specificity was 97.3%. The sensitivity and specificity of TVS in diagnosis of polyp in comparison to HPE were 9.09% and 93.24%, respectively. Conclusion: TVS had a high sensitivity to detect fibroids but its value in detecting hyperplasia and polyps was in question in this study. But hysteroscopy had a maximum sensitivity to detect polyps and high sensitivity to detect endometrial hyperplasia compared to histopathology which is a gold standard investigation.

scholarly journals Histopathological evaluation of Endometrium hyperplasia and it’s correlation with the clinical parameters in a tertiary care hospital

2021 ◽  
Vol 6 (3) ◽  
pp. 187-190
Author(s):  
Tina Rai ◽  
Upasana Uniya ◽  
Archana Shrivastava ◽  
G.S Rai
Keyword(s):  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Underlying Disease ◽  
Uterine Bleeding ◽  
Clinical Parameters ◽  
Care Hospital ◽  
Age Group ◽  
Proper Management

: 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.

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.

Clinico-Pathological Co-relation in Diagnosis and Management of Abnormal Uterine Bleeding

2019 ◽  
Vol 17 (2) ◽  
pp. 52-54
Author(s):  
Durga BC ◽  
Nirmala Sharma
Keyword(s):  
Clinical Presentation ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Diagnostic Tools ◽  
Age Group ◽  
Diagnosis And Management ◽  
Histopathological Evaluation ◽  
Endometrial Pattern ◽  
Common Clinical Presentation

Abnormal uterine bleeding is the third most common clinical presentation in gynecology OPD. Histopathological evaluation of the endometrial tissue plays a significant role in diagnosis and management of Abnormal Uterine Bleeding. Aim: To find out cause of abnormal uterine bleeding with the help of histopathological report of endometrial biopsy. Methodology: This is retrospective observational study done at NGMC from ( 1st June 2018 to -30th June 2019) of 100 patients endometrial biopsy sent for histopathological evaluation and diagnosis reports were correlated with age and bleeding pattern and patients were managed accordingly. Result: A total of 100 endometrial specimens submitted with clinical diagnosis of Abnormal Uterine Bleeding were studied. Patients age group ranged from 18 – 65 yrs and most of them were seen in the age group of 41–50 yrs (43%).The commonest complaint was menorrhagia i.e. 48% .The commonest endometrial pattern observed in the study was, proliferative phase endometrium (38%). Conclusion: Endometrial biopsy is one of the most useful diagnostic tools to find out cause of uterine bleeding in AUB cases and also helps in management of AUB patient.  

scholarly journals Prevalence of adenomyosis and associated gynaecological pathologies in hysterectomy samples: a retrospective study

2021 ◽  
Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Serous Cystadenoma ◽  
Uterine Bleeding ◽  
Research Centre ◽  
Common Symptom ◽  
Age Group ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Case Record

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.

HISTOPATHOLOGICAL STUDY OF ENDOMETRIUM IN WOMEN WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
pp. 30-33
Author(s):  
Bhakti D Deshmukh ◽  
Anuradha Malpani ◽  
Alka V Gosavi ◽  
Kalpana R Sulhyan ◽  
Rucha M Pimpalkhute
Keyword(s):  
Histopathological Examination ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Intraepithelial Neoplasia ◽  
Mucinous Carcinoma ◽  
Uterine Bleeding ◽  
Serous Carcinoma ◽  
Histopathological Study ◽  
Care Hospital ◽  
Age Group

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.

scholarly journals Etiological factors of abnormal uterine bleeding according to PALM- COEIN classification in perimenopausal women in a tertiary care centre

2020 ◽  
Vol 9 (2) ◽  
pp. 799
Author(s):  
Nishi Mitra ◽  
Pooja Patil ◽  
Ayushi Sethia
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Ovulatory Cycle ◽  
New Classification ◽  
Tertiary Care Centre ◽  
Ovulatory Dysfunction ◽  
Perimenopausal Women ◽  
Structural Abnormalities

Background: Perimenopause is described as years prior to menopause that encompasses the change from normal ovulatory cycle to cessation of menses, ending 12 months after the last menses. International federation of gynaecology and obstetrics (FIGO) developed a new classification PALM-COEIN in order to standardize the factors associated with AUB. It classifies AUB as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia (PALM) - structural abnormalities Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified (COEIN) - unrelated to structural abnormalities. Objectives of this study were to categorise the causes of AUB in perimenopausal women in context to PALM COEIN classification system. Correlation of co-morbities (diabetes, hypertension and thyroid disorders) with AUB in perimenopausal age group.Methods: This is a retrospective study from the month of May 2019 to October 2019, considering 100 patients of perimenopausal age group (40 to 55 years of age group) in J. K. Hospital Bhopal, Madhya Pradesh with complaints of abnormal uterine bleeding, admitted in gynae ward.Results: Most of the patients in the current study were between 45-50 years of age i.e. 44%. Menorrhagia was the commonest menstrual disorder encountered in 52% of patients. As per FIGO; AUB-L constituted 42% AUB-O constituted 12%, AUB-P constituted 11%, AUB-A 10%, AUB-M constituted 8% AUB-E constituted 8%, not yet classified constituted 4% of total cases.Conclusions: AUB (PALM-COEIN) for causes of abnormal uterine bleeding classification was very useful in categorizing cases of AUB. It suggests that etiology of AUB and also gives place for presence of multiple factors as a cause of AUB in a particular case.

scholarly journals Histopathological Study of Endometrium in Patients of Perimenopausal Age Group in a tertiary care Hospital in West Bengal

2021 ◽  
Vol 12 (9) ◽  
pp. 84-87
Author(s):  
Nabanita Chakraborty ◽  
Rajasri Chunder ◽  
Barnali Mukherjee ◽  
Soham Chakraborty
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Histological Change ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Care Hospital ◽  
Age Group ◽  
Histological Changes ◽  
Reproductive Life

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.

scholarly journals A comparative study to evaluate endometrial aspiration using Karman’s cannula versus dilatation and curettage in cases of abnormal uterine bleeding

2020 ◽  
Vol 9 (3) ◽  
pp. 1218
Author(s):  
Neetu Sangwan Tomar ◽  
Seerat Sandhu ◽  
Supriya Mahipal ◽  
Abhimanyu Chaudhary
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Aspiration Biopsy ◽  
Age Group ◽  
Vacuum Aspiration ◽  
Dilatation And Curettage ◽  
Normal Menstrual Cycle ◽  
Endometrial Pathology

Background: Abnormal uterine bleeding (AUB) is defined as any variation from the normal menstrual cycle such as changes in regularity, frequency, duration of flow or amount of flow. Objective of this study was to compare the adequacy and diagnostic accuracy of endometrial aspiration using Karman’s cannula versus dilatation and curettage in women with abnormal uterine bleeding.Methods: This prospective study was conducted on 250 women with AUB in age group of more than 40 years. In all patients, endometrial aspiration was done with manual vacuum aspiration (MVA) syringe attached to 4 mm Karman's cannula without anesthesia. The sample was collected in a bottle containing formalin and was labelled as sample A. After that, intracervical local anesthesia (1% Xylocaine) was given and cervix was dilated and scrapping of endometrial lining with sharp curette was done. The sample was also collected in a bottle containing formalin and was labelled as sample B. Both the samples A and B were sent for histopathology. The histopathology report of aspiration was compared with that of dilatation and curettage sample.Results: Endometrial aspiration biopsy had sensitivity of 92.3%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.56% for diagnosis of endometrial pathology while considering D and C gold standard. The sample adequacy of endometrial aspiration was 98.8% as compared to dilatation and curettage (98%).Conclusions: Present study showed that endometrial aspiration biopsy is an alternate to traditional dilatation and curettage in diagnosing endometrial pathologies in women with abnormal uterine bleeding.

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