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 A retrospective study of endometrial histopathology in abnormal uterine bleeding patients

2018 ◽  
Vol 7 (10) ◽  
pp. 4116
Author(s):  
Neha Varun ◽  
Nidhi Gupta ◽  
Sana Khan
Keyword(s):  
Retrospective Study ◽  
Endometrial Hyperplasia ◽  
Diagnostic Procedure ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Age Group ◽  
Medical College ◽  
Different Types ◽  
Proliferative Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the most commonly encountered gynecological problem and almost 33 % of women in gynecological outpatient department presented with abnormal uterine bleeding. Dilatation and curettage (D and C) have been the main diagnostic procedure in the evaluation of abnormal uterine bleeding patients for decades. The objective of the present study was to analyze the different types of endometrial histopathology of patients presented with the abnormal uterine bleeding and its correlation with the different types of abnormal uterine bleedingMethods: This is a retrospective study, conducted in a medical college in the Department of Obstetrics and Gynecology over a period of one year from June ’17 to June ’18. All cases of AUB more than 35 years of the age group who underwent D and C procedure were included in this study. Total 100 patients were analyzed.Results: Total 100 patients were analyzed. Age group ranges from 35-58 years and most common age group presenting with AUB was 35-39 years. The most common presenting complaint was menorrhagia 54% (54/100). Histopathology of endometrium showed non-organic causes in 80% (80/100) of AUB patients and the remaining 20% (20/100) had organic causes. Most common endometrial histopathology among non-organic causes was proliferative endometrium 43.75% (35/80) and the most common organic cause was endometrial polyp 40% (8/20). Endometrial hyperplasia was found in 30% (6/20) and endometrial carcinoma was found in 20% (4/20) of cases among organic causes.Conclusions: D and C is the useful and the cost-effective diagnostic procedure in the evaluation of AUB. Histopathological evaluation of endometrial samples is especially indicated in AUB patients to rule out carcinoma and preneoplastic conditions as histopathology is 100% diagnostic in cases of endometrial hyperplasia and carcinoma.

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.

scholarly journals Retrospective study of histopathological pattern of endometrium in abnormal uterine bleeding

2020 ◽  
Vol 9 (4) ◽  
pp. 1346
Author(s):  
A. Shantha ◽  
Nazia Hussain
Keyword(s):  
Retrospective Study ◽  
Social Life ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
Considerable Morbidity

Background: Abnormal uterine bleeding (AUB) is a common gynaecological complaint associated with considerable morbidity. It significantly affects the patient’s family personal and social life. The aim of this study was to analyse the histopathological patterns of endometrium in patients presenting with AUB.Methods: This is a retrospective study conducted in the teaching hospital in the department of obstetrics and gynecology along with the pathology department. All patients with AUB were included in the study. This study of 138 samples both from hysterectomy specimens and endometrial biopsy were included.Results: The specimen obtained for examination of the endometrial samples 86 comprised from dilatation and curettage and rest 52 samples were obtained from hysterectomy specimens. Most common histopathological pattern was found to be proliferative endometrium, followed by disordered proliferative endometrium and atropic endometrium.Conclusions: Study of the histopathological pattern of the endometrial biopsies can be included in the initial evaluation of women with AUB when the cause of bleeding is not known along with ultrasound examination, then using it as the last modality for diagnostic and therapeutic purposes, irrespective of age group.

scholarly journals Ormeloxifene in the management of dysfunctional uterine bleeding

2018 ◽  
Vol 7 (5) ◽  
pp. 1885
Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar
Keyword(s):  
Side Effects ◽  
Medical Management ◽  
Abnormal Uterine Bleeding ◽  
Cost Effective ◽  
Uterine Bleeding ◽  
Brand Names ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Receptor Modulator ◽  
One Year

Background: Dysfunctional Uterine Bleeding (DUB), is the commonest cause of Abnormal Uterine Bleeding (AUB). It causes morbidity, anaemia, and unnecessary hysterectomies in women of fertile age group. This study attempts to study efficacy of medical management especially Selective Estrogen Receptor Modulator (SERM) namely Ormeloxefine (ORM) (Sevista®) in Perimenopausal women. Ormeloxifene was marketed in India for contraception under brand names Centron, Saheli, Choice-7, Novex and Novex-DS. It’s a benzopyran derivative also known as Centchroman which causes asynchronousity between ovulation and menstrual cycles possibly because of both estrogenic and anti-estrogenic actions. It has been known to cause delay in ovulation in clinical trials; however, majority have been unaffected. It causes delay in proliferation of endometrium thereby causing asynchronous cycles. It also improves motility of ciliary lining of Fallopian tubes thereby reducing the chances of implantation of fertilized egg.  Methods: This study is aimed at evaluation of subjective and objective stastical benefits and side effects in treatment of DUB in perimenopausal age group with ORM and commonly used 19 nortestosterone compound (progesterone); Norethisterone (NET).Results: Primary outcome were analyzed at the end of every 3 months and at the end of one year finally. Secondary outcomes of the study in each arm were also assessed. There was stastically significant increase in Hb and stastically significant decrease in ET. Data analysis was done for variables in each arm by t-test to estimate the mean, median, range P and t value for a conclusion. Differences were taken as significant when P<0.05.Conclusions: ORM is a safe, cost effective, non-steroidal, non-hormonal drug with convenient dosage and better compliance for medical management of perimenopausal DUB with minimum focal pathology. Side effects observed need more evaluation with larger sample size to be statistically significant.

scholarly journals A clinicopathological study of dysfunctional uterine bleeding

2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
University Teaching ◽  
Age Group ◽  
Dysfunctional Uterine Bleeding ◽  
Obstetrics And Gynaecology ◽  
Proliferative Endometrium ◽  
One Year ◽  
Complete History

Background: Dysfunctional uterine bleeding is a form of abnormal uterine bleeding when there is absence of organic disease of the genital tract. The objective of this study was to find out the clinical and pathological aspect of women presenting with dysfunctional uterine bleeding.Materials and Methods: A descriptive study was conducted over a period of one year from April 14th 2010 to April 13th 2011 in the Department of Obstetrics and Gynaecology and Department of Pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A complete history, clinical examination, pelvic scan, hormonal status if required and endometrial biopsy were done to diagnose dysfunctional uterine bleeding.Results: A total of 120 cases were included. The age of the patients diagnosed dysfunctional uterine bleeding were ranging from 24 -63 years. Dysfunctional uterine bleeding was most common in the age group 40-44 yrs (30%) followed by 45-49 yrs (27.5%). Menorrhagia (41.7%) was the most common presenting sign. Majority histopathology of endometrium revealed anovulatory pattern (61.7%) followed by ovulatory (38.3%). Of the cases with an anovulatory pattern 48.6% was proliferative endometrium, 33.8% disordered proliferative endometrium, 6.8%atrophic, 5.4% weakly proliferative and 2.7% each of simple hyperplasia without atypia and complex hyperplasia with atypia. All cases with ovulatory pattern showed secretory endometrium.Conclusion: Dysfunctional uterine bleeding was the most common in the perimenopausal age group and chiefly in the form of an anovulatory endometrium. . Histopathological evaluation of endometrium helps exclude the local causes and establishes the diagnosis of dysfunctional uterine bleeding, its types, and clinical correlation to histopathological findings and finally helps to determine the mode of management.DOI: http://dx.doi.org/10.3126/jpn.v4i8.11500 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 635-638

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 Diagnostic hysteroscopy in abnormal uterine bleeding: a five years study in Kathmandu university hospital

2017 ◽  
Vol 3 (5) ◽  
pp. 128
Author(s):  
Abha Shrestha ◽  
Bhagirathi Kayastha ◽  
Ramesh Makaju
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
University Hospital ◽  
Histopathologic Examination ◽  
Diagnostic Modality ◽  
Submucous Myoma ◽  
Dilatation And Curettage ◽  
Proliferative Endometrium ◽  
Method Of Evaluation ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Abnormal uterine bleeding is the cause of concern, inconvenience and discomfort to many ladies, this affects millions of women in both developed and developing world.  Until recent times, dilatation and curettage was the usual method of evaluation .This detects the cause of bleeding in less than 50% of the cases, but hysteroscopy is a better diagnostic modality and prompt treatment can be provided in the same setting.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was carried out in the Department of Obstetrics and Gynecology at Dhulikhel hospital, Kathmandu University Hospital, Kavre, Nepal from January 2010 to January 2016. Two hundred and eighteen cases were enrolled in this study. Patients with abnormal uterine bleeding above the age of 18 years were enrolled. Hysteroscopic examination was done in all patients after the pregnancy was ruled out with urine pregnancy test and ultrasonology. The patients then underwent hysteroscopic guided endometrial sampling and endometrium was sent for histopathologic examination. The correlation between findings on hysteroscopy and histopathologic examination was tabulated. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> Following were the findings on hysteroscopy: proliferative endometrium was in 59%, secretary   endometrium was in 14%,endometrial hyperplasia in 12%, atrophic in 2 %, endometrial polyp in 7%, submucous myoma in  5% and carcinoma of endometrium in 1%.</p><p class="abstract"><strong>Conclusions:</strong> In patients with abnormal uterine bleeding, hysteroscopy provides more accurate diagnosis than dilatation and curettage<span lang="EN-IN">. </span></p>

scholarly journals Histopathological spectrum of endometrium in abnormal uterine bleeding

2018 ◽  
Vol 7 (9) ◽  
pp. 3633 ◽  
Author(s):  
Simridhi Bindroo ◽  
Monika Garg ◽  
Tajinder Kaur
Keyword(s):  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Age Groups ◽  
Healthy Woman ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Age Group ◽  
Proliferative Endometrium ◽  
Histopathological Workup ◽  
Endometrial Carcinomas

Background: Abnormal uterine bleeding (AUB) interferes with the quality of life of an otherwise healthy woman. Until the pathology underlying menorrhagia is, accurately diagnosed, proper therapy is hardly possible. The objective of the study was to analyze different histopathological patterns of endometrium in AUB and observe the incidence of various pathologies in different age groups and their relation to parity.Methods: This two-year prospective studywas done in the department of pathology in atertiary care centre, which included 250 cases of clinically diagnosed AUB patients were evaluated. Histopathological examination of endometrial biopsies and hysterectomy specimens were done, followed by clinical correlation.Results: Out of 250 cases of AUB, Premenopausal bleeding was seen in 216 cases (86.4%) and 34 cases (13.6%) had postmenopausal bleeding. The commonest finding observed in the study was proliferative phase endometrium (37.2%), followed by secretory endometrium (34%) and endometrial hyperplasia (16%). Disordered proliferative endometrium was seen in 2.4% of patients. Endometrial carcinoma was seen in 4 (1.6%) cases. Endometrial hyperplasia was seen mostly in the age group 41-50 years (27 cases). Two cases of endometrial carcinomas were presented after age 60 years.Conclusions: Our study revealed the highest incidence of AUB in the perimenopausal age group (41-50 years). Hence a thorough histopathological workup and clinical correlation are mandatory in cases of abnormal uterine bleeding.

scholarly journals Clinical and histopathological presentation of abnormal uterine bleeding in perimenopausal women in tertiary center of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 248-252
Author(s):  
Sadikchha Chapagain ◽  
Ganesh Dangal
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Clinical Feature ◽  
Age Group ◽  
Histopathological Findings ◽  
Tertiary Center ◽  
Perimenopausal Women ◽  
Proliferative Endometrium ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding is defined as any bleeding outside of normal menstruation pattern with excessive duration, frequency, and amount and it is a common problem among women of reproductive age group with varied presentations. The aim of the study was to correlate the histopathological finding in patients with abnormal dysfunctional uterine bleeding with the presenting clinical feature.Methods: A prospective cross sectional study was carried out at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu during the period of one year (February 2019 to January 2020). It included 77 perimenopausal women with abnormal uterine bleeding who presented in gynecology outpatient department and planned for dilatation and curettage. Then the participants were counselled and informed consent was taken. Histopathological reports reviewed and analysis done. Results: The most common age group of women presenting with abnormal uterine bleeding was 40 to 44 years and the commonest clinical feature was menorrhagia (31/77, 40.3%) followed by menometrorrhagia (18/77, 23.4%). Majority of women were multiparous, parity 3 to 4 (38/77, 49.4%). Proliferative endometrium (29/77, 37.7%) was most common histopathological findings followed by secretory endometrium (24/77, 31.2%). Proliferative endometrium was more commonly associated with menorrhagia and menometrorrhagia whereas secretory endometrium with metrorrhagia (P-value 0.000).Conclusions: Menorrhagia and Menometrorrhagia are the most common clinical presentation among perimenopausal women with AUB, whereas proliferative endometrium and secretory endometrium were the common histopathological findings respectively.Accurate diagnosis is crucial for a selection of relevant treatment and avoidance of unnecessary major surgical procedure. Keywords: Abnormal uterine bleeding; endometrium; histopathology; perimenopausal.

scholarly journals Centchroman use in dysfunctional and abnormal uterine bleeding after D and C

2018 ◽  
Vol 7 (9) ◽  
pp. 3502
Author(s):  
Piyusha Chandrayan ◽  
Foram H. Naik ◽  
Deepak A. Desai
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Poor Response ◽  
Uterine Bleeding ◽  
The Body ◽  
Common Side Effect ◽  
Medical Illness ◽  
Age Group ◽  
Proliferative Phase ◽  
Hospital Patients ◽  
Proliferative Endometrium

Background: Incidence of DUB is more in the age group of 30-35yr and is about 35%-40%. Medical management (Centchroman) can be the treatment of preference, after excluding any organic pathology in uterus. To evaluate efficacy and side effects of Saheli (Centchroman) in case of dysfunctional uterine bleeding will depend upon the type of endometrium as determined histologically after minor procedure, D&C (Dilatation and Curettage). This drug will be used only in the presence of Proliferative Endometrium on Histopathological Examination.Methods: The study was carried out at Dhiraj Hospital, Piparia. It was an Interventional Study. 50 patients were studied in 6 months of period, 25 each of DUB and AUB. A total of 50 patients were enrolled in this study, who were attending or were admitted in the hospital. Patients who meet the inclusion criteria were included in this study, after taking prior written and informed consent.Results: Most of the patient were in the age group 39-45 years. The common complaint was excessive uterine bleeding, for which they were prescribed Centchroman. Most of the DUB patients were relieved on medication. However, few of them who had poor response to drug went for hysterectomy. It was observed that patients with early proliferative phase on HPE had better response to this drug as compared with late proliferative phase. All the patients with late proliferative phase underwent hysterectomy. Most patient with AUB including Fibroid, Adenomyosis, Endometrial hyperplasia had little or no response went for hysterectomy sooner or later on after therapy in 50% cases. Centchroman is relatively a safe drug. The most common side effect encountered was breakthrough spotting in 15 patients. 4 patients complained of amenorrhoea after 3 months of taking this drug and 1 patient complained of itching and rash over the body. No major complications were noted.Conclusions: Centchroman can be an effective non hormonal drug used for menorrhagia with proliferative endometrium with early changes in patients of DUB. This drug can also be used to control menorrhagia in patients with fibroid. This is also beneficial in patients with menorrhagia with medical illness to avert hysterectomy.

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