scholarly journals Clinical Factors Associated With Anxiety and Depression in Korean Women With Abnormal Uterine Bleeding

2020 ◽  
Author(s):  
Hae Nam Lee ◽  
Ji Min Seo ◽  
Gi Soo Um ◽  
Min Jeong Kim
Keyword(s):  
Depressive Disorders ◽  
Health Management ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
University Hospital ◽  
Menstrual Bleeding ◽  
Anxiety And Depression ◽  
Korean Women ◽  
History Of

Abstract Background: Abnormal uterine bleeding (AUB) is defined as an abnormality in menstrual bleeding and is common gynecological problem in premenopausal women. Anxiety and depressive disorders were frequently observed in patients with AUB. This study was conducted to investigate the prevalence and the relationship of anxiety and depression in Korean women with AUB.Methods: The study was a questionnaire study of 124 Korean women aged 15–55 who admitted a single university hospital due to AUB between September 2015 and December 2019. Anxiety, depression were assessed using the Korean Beck Anxiety Inventory (K-BAI), the Korean Beck Depression Inventory-II (K-BDI-II). The obstetrical and clinical data were analyzed to assess the association of anxiety and depression with AUB.Results: Out of 124 patients, 47 (37.9%) met the criteria for anxiety, and 24 (19.5%) met the criteria for depression. The most common menstrual problems seen were heavy menstrual bleeding (80.7%), followed by irregular bleeding (62.9%), dysmenorrhea (55.7%), and irregular menstrual cycles (33.9%). More women with AUB in our study had anxiety as measured by the K-BAI and depression as measured by the K-BDI-II. A history of abortion and cesarean section were related with anxiety, whereas a history of minor surgery was related to depression. Anxiety and depression (r = 0.629, p < 0.001) were correlated with AUB.Conclusions: Anxiety and depression are underdiagnosed and undertreated in Korean women with AUB symptoms. Screening and appropriate mental health management are needed for women with AUB for women’s health.

scholarly journals Abnormal Uterine Bleeding in Adolescent

2021 ◽  
Vol 4 (2s) ◽  
pp. 15-22
Author(s):  
Evelyne Theresia ◽  
◽  
Andreas Christoper ◽  
Melissa Edelweishia
Keyword(s):  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Hemodynamic Instability ◽  
Uterine Bleeding ◽  
Warning Signs ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
History Of ◽  
Flow Treatment

Abstract Abnormal uterine bleeding (AUB) is a frequent cause of visits to health care provider during adolescent period. Heavy menstrual bleeding is the most frequent clinical presentation of AUB. This condition particularly worrisome in this group not only when it occurs at menarche, but also anytime afterward when bleeding lasts longer than 7 days, blood loss is greater than 80 mL per cycle, or other warning signs that indicate a history of heavy bleeding such as anemia. Careful history and examination can help elucidate the best next steps for workup and management. The primary goal of treatment is prevention of hemodynamic instability. Therefore, assessing the severity and cause of bleeding is important. Therapeutic approach in the acute period should be established according to the degree of anemia and amount of flow. Treatment options for medical care of AUB generally include hormonal, nonhormonal and surgery. Additionally, long-term management with hormonal therapy in patients with severe uterine bleeding is known to be safe for developing HPO axis. Keyword: Abnormal uterine bleeding, adolescents, heavy menstrual bleeding

scholarly journals Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Luca Giannella ◽  
Lillo Bruno Cerami ◽  
Tiziano Setti ◽  
Ezio Bergamini ◽  
Fausto Boselli
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Prediction Model ◽  
Endometrial Hyperplasia ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Stepwise Logistic Regression ◽  
Simultaneous Presence ◽  
Endometrial Pathology

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.

Rate of Prophylaxis Oophorectomy and Associated Factors at the Time of Hysterectomy in Premenopausal Women with Benign Diseases

2021 ◽  
Vol 104 (5) ◽  
pp. 709-714
Keyword(s):  
Associated Factors ◽  
Premenopausal Women ◽  
Abdominal Hysterectomy ◽  
University Hospital ◽  
Benign Diseases ◽  
Prophylactic Oophorectomy ◽  
Gynecologic Oncologist ◽  
Menstrual History ◽  
History Of ◽  
Operative Notes

Objective: To determine the rate of oophorectomy and associated factors at the time of hysterectomy in premenopausal women with benign diseases. Materials and Methods: The medical records of the premenopausal women that underwent hysterectomy with or without oophorectomy due to benign gynecologic conditions between January 1, 2012 and December 31, 2017 at Khon Kaen University Hospital (Thailand) were retrospectively reviewed. The data collected included age, BMI, parity, indication for surgery, family history of carcinoma, route of hysterectomy, procedure, specialization of the surgeon, operative notes, and histopathological reports of the ovaries. Results: Six hundred thirty-eight subjects underwent hysterectomy due to benign gynecologic conditions. Bilateral salpingo-oophorectomy (BSO) was performed in 57.37% (366) of the cases. In 81.97% (300) of these cases, either one or both patient’s ovaries were grossly normal. The rate of prophylactic oophorectomy among all cases was 47.02% (300 in 638). The strongest associated factor with BSO was age (odds ratio 8.421, 95% CI 5.488 to 12.921). Other associated factors were irregular menstrual history, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. No cases of ovarian cancer were found. Conclusion: Nearly half of premenopausal women that underwent hysterectomy due to benign conditions underwent prophylactic oophorectomy. Associated factors were age, irregular menstruation, the surgeon being a gynecologic oncologist, and abdominal hysterectomy. Keywords: Hysterectomy, Premenopausal women, Prophylactic oophorectomy

scholarly journals Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

2017 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Histopathological Findings ◽  
Number Of Patients ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 

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 Practice points in gynecardiology: Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy

Maturitas ◽  
2015 ◽  
Vol 82 (4) ◽  
pp. 355-359 ◽  
Author(s):  
Angela H.E.M. Maas ◽  
Mia von Euler ◽  
Marlies Y. Bongers ◽  
Herbert J.A. Rolden ◽  
Janneke P.C. Grutters ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Oral Anticoagulant ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding

2004 ◽  
Vol 14 (1) ◽  
pp. 57-63 ◽  
Author(s):  
M. A. Guven ◽  
T. Bese ◽  
F. Demirkiran
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Normal Endometrium ◽  
Pathologic Findings ◽  
History Of ◽  
Sensitivity Specificity

BackgroundThe aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding.Study designProspective, randomized, and unblinded study.Material and methodsA total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 ± 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure.ResultsThe surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results.ConclusionHydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.

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