scholarly journals Avaliação ultrassonográfica no espessamento endometrial: revisão de literatura

2017 ◽  
Vol 4 (4) ◽  
pp. 60
Author(s):  
Débora Filardi Silveira ◽  
Carlos Alberto Rodrigues Junior ◽  
Fellipe Camargo Ferreira Dias ◽  
Camila Filardi Silveira ◽  
Caroline Filardi Silveira
Keyword(s):  
Transvaginal Ultrasound ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Female Population ◽  
Ultrasound Evaluation ◽  
Endometrial Pattern ◽  
Uterine Mucosa ◽  
Uterine Synechia ◽  
Uterine Diseases

Introdução: A avaliação ecográfica do endométrio permite a análise minuciosa da mucosa uterina na prática clínica ginecológica, com o intuito de auxiliar no manejo das patologias endometriais. Neste artigo, fazemos uma revisão narrativa para avaliar o real papel da ecografia pélvica na visualização das doenças endometriais. As alterações uterinas, como pólipos, miomas, sinéquias uterinas, hiperplasia e câncer endometrial são morbidades frequentes na população feminina, tanto nas pacientes em idade reprodutiva como nas que estão na pós-menopausa. Os métodos de avaliação endometrial têm obtido diversos avanços nos tempos atuais, sendo o ultrassom transvaginal o método de escolha para investigação inicial das doenças endometriais, tanto nas pacientes com sangramento genital, quanto nas mulheres assintomáticas principalmente na pós-menopausa. Conclusão: A ecografia é o exame primordial e elementar na investigação de pacientes com sangramento uterino anormal ou sob suspeita de outras doenças que alteram o padrão endometrial, conduzindo o prognóstico do quadro investigado.   Palavras-chave: Ultrassonografia, Doenças Uterinas, Endométrio. ABSTRACT Introduction: The ultrasound evaluation of the endometrium allows a detailed analysis of the uterine mucosa in gynecological clinical practice, in order to assist in the management of endometrial pathologies. In this article, we make a narrative review to evaluate the real role of pelvic ultrasound in the visualization of endometrial diseases. Uterine changes such as polyps, fibroids, uterine synechia, hyperplasia, and endometrial cancer are frequent morbidities in the female population, both in postmenopausal and post-reproductive age patients. Methods of endometrial evaluation have achieved several advances in the present times, with transvaginal ultrasound being the method of choice for the initial investigation of endometrial diseases, both in patients with genital bleeding and in asymptomatic women, especially postmenopausal women. Conclusion: Ultrasonography is the primary and elemental examination in the investigation of patients with abnormal uterine bleeding or under suspicion of other diseases that alter the endometrial pattern, leading to the prognosis of the investigated condition. Keywords: Ultrasonography, Uterine Diseases, Endometrium.

CLINICAL CASE OF SUCCESSFUL TREATMENT OF INFERTILITY IN A PATIENT WITH FAILURE IVF RESULTS IN ANAMNESIS

2020 ◽  
pp. 61-67
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Assisted Reproductive Technologies ◽  
Transvaginal Ultrasound ◽  
Clinical Manifestations ◽  
Reproductive Function ◽  
Abnormal Uterine Bleeding ◽  
Clinical Situation ◽  
Reproductive Technologies ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Number Of Publications

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.

scholarly journals Comparison between Different Diagnostic Strategies in Low-Risk Reproductive Age and Pre-Menopausal Women Presenting Abnormal Uterine Bleeding

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 884
Author(s):  
Chiara Belcaro ◽  
Federica Scrimin ◽  
Alessandro Mangogna ◽  
Emanuele Filippo Galati ◽  
Stefania Biffi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Low Risk ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Female Population ◽  
Diagnostic Strategies ◽  
Study Results

Abnormal uterine bleeding (AUB) is a common symptom in the female population, with an estimated prevalence of 10 to 30% in fertile age and up to 90% in perimenopausal women. In most cases, AUB is due to a benign cause. However, it can also be a symptom of atypical endometrial hyperplasia or endometrial cancer, a more common disease during menopause which can also affect women in their reproductive age. Considering the high prevalence of this symptom an appropriate diagnostic algorithm is needed. Concerns about the risks, pain, and stress associated with an endometrial biopsy and its impact on the healthcare system make the choice of AUB diagnostic strategy extremely relevant. Even if the scientific community agrees on the definition of AUB, International Guidelines show some differences in the management of women of reproductive age with AUB, especially regarding the age cut-off as an independent indication for endometrial biopsy. This study compared different diagnostic strategies to identify a diagnostic pathway with high sensitivity and specificity but low impact on the health system’s resources. The analysis was based on three diagnostic algorithms defined as part of the guidelines of leading scientific societies. Women of reproductive age with AUB (n = 625) and without risk of endometrial cancer were included in the study. Results showed that the best criterion to investigate AUB in women at low risk of endometrial cancer is not age cut-off but the presence or absence of focal endometrial pathology at the ultrasound and the response to the progestin therapy. This approach makes it possible to perform fewer outpatient hysteroscopic biopsies without excluding positive cases from the examination.

scholarly journals Role of Ultrasound in the Evaluation of Abnormal Vaginal Bleeding in Nonpregnant Patients in Reproductive Age

2012 ◽  
Vol 6 (1) ◽  
pp. 112-120
Author(s):  
Bailey Wilson ◽  
Sanja Kupesic Plavsic
Keyword(s):  
Vaginal Bleeding ◽  
Obstet Gynecol ◽  
Color Doppler ◽  
Abnormal Uterine Bleeding ◽  
Color Doppler Ultrasound ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Ultrasound Findings ◽  
Abnormal Vaginal Bleeding

ABSTRACT Abnormal uterine bleeding is defined as any alteration in the volume, pattern or duration of menstrual blood flow. Abnormal uterine bleeding can be due to a number of organic and dysfunctional causes. This article presents different case scenarios of nonpregnant reproductive age patients presenting with abnormal genital tract bleeding. These cases will allow the reader to identify differential diagnoses related to each scenario and to understand ultrasound findings typical for nonpregnant patients presenting with abnormal vaginal bleeding. The role of B-mode and color Doppler ultrasound in the evaluation of abnormal uterine bleeding is described. Standard treatment methods are also listed for each case. How to cite this article Wilson B, Plavsic SK. Role of Ultrasound in the Evaluation of Abnormal Vaginal Bleeding in Nonpregnant Patients in Reproductive Age. Donald School J Ultrasound Obstet Gynecol 2012;6(1):112-120.

scholarly journals Spectrum of endometrial lesions observed on histopathological examination of endometrial samples in women with abnormal uterine bleeding

2019 ◽  
Vol 7 (11) ◽  
pp. 4124
Author(s):  
Smriti S. Dwivedi ◽  
Malay Bajpai ◽  
Indu Bhushan ◽  
Arunima Satkirti
Keyword(s):  
Endometrial Hyperplasia ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Age Group ◽  
Hormonal Imbalance ◽  
Endometrial Pattern ◽  
Reproductive Age Group

Background: Abnormal uterine bleeding is one of the common gynecological complaints of women of all age groups. Histopathological study of endometrial biopsy and curettage samples is an effective diagnostic modality that can be used to identify cause of AUB at its earliest. This study was done to investigate the various endometrial causes of AUB that frequently come to our hospital and their incidence in various age groups i.e. reproductive, perimenopausal and postmenopausal.Methods: This study was conducted on 108 patients who clinically presented with AUB and had their endometrial biopsy and curettage specimens sent to the histopathology department of our tertiary care hospital and teaching centre, located in Uttar Pradesh from June 2018 to May 2019. The endometrial patterns were observed, and their frequencies and percentages were computed and classified age group wise.Results: These studies included patients with age range from 19 to 77 years. The predominant age group with AUB was reproductive age group (<40 years). The most common histopathological finding in this study was normal menstrual pattern (48.15 %). The endometrial pathologies observed were hormonal imbalance and pill effect (22.22%), atrophic endometrium (10.19%), chronic endometritis (5.56%), benign endometrial polyp (4.63%), gestation products (3.70%), endometrial hyperplasia (3.70%), and endometrial carcinoma (1.85%). Conclusion: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.Conclusions: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.

scholarly journals The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Attilio Di Spiezio Sardo ◽  
Gloria Calagna ◽  
Fabrizia Santangelo ◽  
Brunella Zizolfi ◽  
Vasilis Tanos ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Incidental Finding ◽  
Imaging Techniques ◽  
Uterine Cavity ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Uterine Adenomyosis ◽  
Improving Accuracy

Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control. Hysteroscopy is not a first-line treatment approach for adenomyosis and it represents a viable option only in selected cases of focal or diffuse “superficial” forms. During office hysteroscopy, it is possible to enucleate superficial focal adenomyomas or to evacuate cystic haemorrhagic lesions of less than 1.5 cm in diameter. Instead, resectoscopic treatment is indicated in cases of superficial adenomyotic nodules > 1.5 cm in size and for diffuse superficial adenomyosis. Finally, endometrial ablation may be performed with the additional removal of the underlying myometrium.

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

2018 ◽  
Vol 7 (12) ◽  
pp. 5037
Author(s):  
Jessy Varghese ◽  
Jeyashambavi J. ◽  
Deepa S.
Keyword(s):  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Age Group ◽  
Endometrial Pattern ◽  
Proliferative Endometrium ◽  
A Prospective Study

Background: Abnormal uterine bleeding is one of the most common complaint that reproductive age women bring to their clinicians. Causes are varied and study of endometrium by dilatation and curettage with histopathological examination is an important aspect of treating patients with Abnormal uterine bleeding (AUB). The present study was done for evaluation of the histopathology of the endometrium for identifying endometrial causes of AUB.Methods: A prospective study was conducted over a period of one year from July 2017 to July 2018 in the department of Obstetrics and Gynaecology in collaboration with the department of Pathology at Aarupadai Veedu Medical College, Puducherry. A complete clinical history, complete clinical examination, laboratory investigations, pelvic scan and endometrial biopsy were done to diagnose causes of AUB.Results: A total of 152 cases are included. The age of the patients having AUB was ranging from 21 to 70 years. AUB was more common the age group in the age group 41-50 years (49%) followed by 31-40 years (36%). Majority were multiparous (74%). Menorrhagia (61%) was the commonest presentation. Majority of the cases showed a disordered proliferative endometrial pattern (34.2%), followed by secretory pattern (25%). 9.8% had polyp and 1.3% showed simple hyperplasia and 0.62% revealed complex hyperplasia without atypia and carcinoma endometrium.Conclusions: Abnormal uterine bleeding was more common in the perimenopausal age group and majority had disordered proliferative endometrium and secretory changes. Endometrial sampling followed by histopathological examination helps us to diagnose the underlying pathology and will help in treating the patients appropriately including ruling out premalignant and malignant conditions of the uterus.

scholarly journals A Case of Primary Uterina Lymphoma Presenting with Bleeding, Pelvic Pain, and Dysmenorrhea

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Lilian Yukari Miura ◽  
Miriam Anyury Daquin Maure ◽  
Monica Tessmann Zomer ◽  
Reitan Ribeiro ◽  
Teresa Cristina Santos Cavalcanti ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Genital Tract ◽  
Transvaginal Ultrasound ◽  
Female Genital Tract ◽  
Abnormal Uterine Bleeding ◽  
Laparoscopic Hysterectomy ◽  
Primary Lymphoma ◽  
Female Population ◽  
Histologic Evaluation ◽  
Female Genital

Primary non-Hodgkin’s lymphoma (NHL) can arise from lymphatic cells located in solid organs (extranodal) and it accounts for 25 to 35% of all NHL. Primary lymphoma on the female genital tract (PLFGT) is a rare disease, comprising 0.2 to 1.1% of all extranodal lymphomas in the female population. In this paper, the authors report an extremely rare case of a 48-year-old woman who exhibited an abnormal uterine bleeding, pelvic pain, and dysmenorrhea history. The transvaginal ultrasound showed an anteverted uterus measuring 153 cm3 in volume, with intramural leiomyomas. She underwent a total laparoscopic hysterectomy with bilateral salpingectomy. The histologic evaluation of the specimen showed a follicular lymphoma with diffuse pattern in the endometrium. This report illustrates the difficulty in the diagnosis of primary lymphomas of the female genital tract.

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