scholarly journals Role of pipelle versus dilatation and curettage in tissue diagnosis abnormal uterine bleeding

2020 ◽  
Vol 8 (9) ◽  
pp. 3223
Author(s):  
Markad Swapnil Balaram ◽  
Roopa R. Shinde ◽  
C. Suresh Babu ◽  
Hamid Mubashar Mohamed Mubasher ◽  
Ranoji Vijaysing Shinde
Keyword(s):  
Histopathological Examination ◽  
Tissue Sample ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Diagnostic Value ◽  
Uterine Bleeding ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Post Menopausal

Background: Menstrual irregularities and abnormal heavy menstruation account for up to 26-35% of women attending Gynecological outpatient Department. Abnormal Uterine Bleeding (AUB), it is more common at extremes of age endometrial hyperplasia occurs in 5-10% of patients with post-menopausal bleeding out of which atypical hyperplasia has 26-32 % risk of having malignancy in future. Therefore, endometrial sampling for histopathology is important in the assessment of abnormal uterine bleeding is mandatory. Our study was conductive to know the effectiveness of pipelle type devices, versus Dilatation and curettage in obtaining quality endometrial tissue for histopathological examination.Methods: The study was undertaken in Department of obstetrics and gynaecology along with department of Pathology at Rajarshi Chhatrapati Shahu Maharaj, government medical college, Kolhapur after getting approval from the Hospital Committee on Clinical Research and Ethical Committee of the institution, during the period from October 2016 to March 2017 (six months). Total number of subjects included in study is Hundred after taking into consideration of inclusion and exclusion criteria.Results: The ease of doing procedure was much easier as compared to D&C and the Tissue sample obtained for histopathological examination were as par D&C. It was concluded that histopathology report was available in 92 of the 100 pipelle samples and 93 of 100 D&C samples. It was also, observed that increased endometrial thickness was not always associated with adequate tissue diagnosis.Conclusions: Pipelle is simple, affordable, patient friendly can be easily performed with minimal training, which can be performed in Outpatient Gynaecological Department. The diagnostic value and positive predictive value of Pipelle is at par with conventional D&C. So, pipelle can be recommended for all perimenopausal patients with AUB to rule out various, premalignant and malignant conditions of the endometrium.

scholarly journals Diagnostic role of hysteroscopy in abnormal uterine bleeding: a comparative study of hysteroscopy findings with histopathology from Mysore, South India

2019 ◽  
Vol 8 (2) ◽  
pp. 398
Author(s):  
Mamatha Shivanagappa ◽  
Vinutha K. Veerabhadrappa ◽  
Madhumitha Mahesh
Keyword(s):  
Diagnostic Technique ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Normal Endometrium ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Diagnostic Role ◽  
Diagnostic Hysteroscopy ◽  
Diagnostic Work

Background: Dilatation and curettage has long been the diagnostic gold standard for abnormal uterine bleeding. However, even a trained gynecological curettes at best 70-80% of the endometrium. Hysteroscopy is gaining acceptability over other diagnostic technique like dilatation and curettage, hysterosalpingogram and ultrasound. The objective of this study is to find out the role of hysteroscopy in abnormal uterine bleeding and to compare hysteroscopy findings with histopathology.Methods: Fifty patients in perimenopausal age group with abnormal uterine bleeding attending JSS Medical College and Hospital Mysore, during the period 1999-2001 were studied by diagnostic hysteroscopy followed by dilatation and curettage.Results: Mean age of the study group was 44.3% years (±2.5 SD). Menorrhagia was the commonest symptom and was found in 68% of the patients. Diagnostic hysteroscopy identified 23 cases as Normal endometrium, 16 cases as endometrial hyperplasia, 3 cases as atrophic endometrium, 4 cases as endometrial polyp, 4 cases as fibroids. Compared with histopathological findings as definitive diagnosis, hysteroscopy correctly picked up 19 cases of (86.9%), normal endometrium, 12 cases of hyperplasia (75%), 3 cases of atrophic endometrium (100%), 4 cases of polyps (100%), and 4 cases of fibroid (100%).Conclusions: Hysteroscopy should be considered as a basic and essential diagnostic procedure in the diagnostic work up of abnormal uterine bleeding. 

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.

scholarly journals Abnormal Uterine Bleeding in Perimenopausal Age: Different causes and its relation with histopathology

2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Nazlima Nargis ◽  
Iqbal Karim ◽  
Khondaker Bulbul Sarwar
Keyword(s):  
Histopathological Examination ◽  
Medical Science ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Histopathological Findings ◽  
Medical College ◽  
Gynecology And Obstetrics ◽  
Study Results

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139

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.

scholarly journals Role of hysteroscopy and histopathology in evaluating patients with abnormal uterine bleeding

2017 ◽  
Vol 6 (2) ◽  
pp. 615 ◽  
Author(s):  
Nighat Firdous ◽  
Samar Mukhtar ◽  
Sheikh Bilal ◽  
Salma Kounsar Beigh
Keyword(s):  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Endometrial Polyps ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Definitive Role

Background: Abnormal uterine bleeding is one of the leading causes for seeking gynaecological advice. The aim and objectives of the study was to determine the pattern of hysteroscopic abnormalities and histopathological features of Abnormal Uterine Bleeding and to correlate hysteroscopic findings with histopathological findings.Methods: The present study “Role of Hysteroscopy and Histopathology in Evaluating patients with Abnormal Uterine Bleeding” was an observational study carried out in the Postgraduate Department of Obstetrics and Gynaecology and Postgraduate Department of Pathology of Government Medical college, Srinagar after obtaining clearance from the institutional ethical committee. The period of the study was One and a Half Years from April 2014 to September 2015.Results: The most common abnormality detected by hysteroscopy was Endometrial Hyperplasia (27 cases, 27%) followed by endometrial polyps (21 cases, 21%). Endometrial Hyperplasia was the most common abnormality found in Menorrhagia followed by polyps while polyps were the most common finding in polymenorrhea and endometrial hyperplasia was the most common pathology in postmenopausal bleeding. Hysteroscopy had a sensitivity of 93.2%, specificity of 83.9%, positive predictive value of 82%, Negative Predictive Value of 94% in diagnosing etiology of abnormal uterine bleeding.Conclusions: This study confirms that hysteroscopy has a definitive role in evaluating patients with abnormal uterine bleeding and hysteroscopy and histopathology complement each other in the evaluation of a patient with Abnormal uterine bleeding.

scholarly journals Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

2016 ◽  
Vol 4 (2) ◽  
pp. 72
Author(s):  
Archana Tiwari ◽  
Narinder Kaur ◽  
Sushila Jain ◽  
Ramji Rai ◽  
Surendra Kumar Jain
Keyword(s):  
Light Microscopy ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Medical College ◽  
Biopsy Specimens ◽  
Neoplastic Lesions ◽  
Post Menopausal

Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details.   Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20.   Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others.   Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB  by histopathology can be life saving with early tissue diagnosis and management.

scholarly journals Role of Injection Depo Medoroxy Progesterone Acetate in the Management of Abnormal Uterine Bleeding in Norplant User

2019 ◽  
Vol 7 (1-2) ◽  
pp. 80-83
Author(s):  
Mahfuz Ara Begum ◽  
Begum Aminun Nahar ◽  
Monowara Sultana ◽  
Md Amjad Ali
Keyword(s):  
Family Planning ◽  
Prospective Study ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Good Option ◽  
Planning Model ◽  
Live Births ◽  
Medical College ◽  
To Receive

Background & objective: This prospective study was undertaken to determine the role of Depomedroxy progesterone acetate (DMPA) in the management of abnormal uterine bleeding associated with norplant use. Methods: The study was carried out in the Department of Family Planning Model Clinic of Sir Salimullah Medical College and Mitford Hospital, Dhaka between June, 2003 to December, 2005. A total 54 clients were consecutively selected, based on predefined enrolment criteria. Results: Over two-thirds (70.6%) of the patients were multipara (2-3 live births), 22% primipara and the rest 7.4% grand-multipara (4 or more live births). Among 54 cases, 45(84%) responded to treatment. Of the 9 (16%) cases who failed to respond to DMPA treatment, 4 cases were given 2nd dose of DMPA. Three cases dropped out after failing the 1st dose and 2 cases refused to receive 2nd dose and their norplant was removed on request. Abnormal per vaginal (P/V) bleeding began from the 1st month of insertion of Norplant with 15 (27.7%) cases in the 1st month, 7(12%) cases between 2nd to 5th months, 16(28%) cases between 6-12 months, 11(20%) between 13-24 months and 5 (9.3%) cases between 25-36 months. Conclusion: The study showed that DMPA is a simple and effective modality of treatment for women with abnormal or irregular uterine bleeding associated with norplant implant use. With increased compliance from clients’ perspective, it could be a good option for treatment of women with abnormal or irregular uterine bleeding caused by norplant implant. Ibrahim Card Med J 2017; 7 (1&2): 80-83

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