scholarly journals ENDOMETRIAL STUDY OF ABNORMAL UTERINE BLEEDING IN WOMEN AT 45 YEARS AND ABOVE

2003 ◽  
Vol 42 (146) ◽  
pp. 83-85
Author(s):  
Ganesh Dangal

ABSTRACTThe study is done to know the causes for the abnormal uterine bleeding in perimenopausal women atChitwan valley and to compare the histopathological findings between the pre-menopausal andpostmenopausal women. Retrospective analysis of patients who have had abnormal bleeding during a periodof one and a half years' from January 2000 to June 2001 in Department of Gynaecological Oncology of BPKoirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. There were total sixty women (aged 45years and above) having abnormal bleeding managed at BPKMCH. A total of sixty patients were studied.Majority (57%) of them was postmenopausal ladies presented with abnormal vaginal bleeding. The agerange was 45 to 81 years. Only 37% had pathological bleeding including malignancies and only about 17%had malignancies. Malignant diseases were found in 7.7% cases in the pre-menopausal ladies whereas itwas 23.4%, almost three times higher, in the post-menopausal ladies. Carcinoma of the cervix and of theendometrium occurred with increasing frequency with increasing age in this study. So, a thorough work-upis needed for the elderly women presenting with an abnormal vaginal bleeding especially to rule outmalignancies.Key Words: endometrial biopsy, endometrial cancer, postmenopausal bleeding.

2017 ◽  
Vol 15 (2) ◽  
pp. 26-31
Author(s):  
Sharmila Parajuli ◽  
Binita Thapa

Introduction: Abnormal uterine bleeding is a common sign of a number of different uterine disorders ranging from dysfunctional (non organic) abnormalities or complications of pregnancy to organic lesions such as polyps, hyperplasia or carcinoma. Methods: This is a retrospective study conducted at Hospital of 2nd author during a period of 5 years (Jan 2008-Dec 2013).  Histopathology records were retrieved and searched for cases of abnormal uterine bleeding. Relevant histopathological findings and clinical data were recorded and analyzed. The aim of the study was to determine the causes for abnormal uterine bleeding in women presenting to the hospital and to compare the histopathological findings at various age groups.Results: The age of patients ranged from 17 to 71 years with an average of 43 years. The most common cause of uterine bleeding was found to be proliferative phase endometrium; that were 649 cases (56.43%). Out of the pathological causes, the most common cause was found to be endometrial hyperplasia- 44 cases (3.82%). Endometrial carcinoma was found to be more common in the elderly postmenopausal women. A total of 6 cases (0.5%) of endometrial carcinoma were present.Conclusion: Endometrial hyperplasias and malignancies are common in increasing age group, especially in perimenopausal and postmenopausal women. So, a thorough work-up and diagnostic endometrial biopsy is therefore mandatory without delay in these patients to rule out malignancies. 


Author(s):  
Bailey Wilson ◽  
Sanja Kupesic Plavsic

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.


2016 ◽  
Vol 4 (2) ◽  
pp. 72
Author(s):  
Archana Tiwari ◽  
Narinder Kaur ◽  
Sushila Jain ◽  
Ramji Rai ◽  
Surendra Kumar Jain

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.


Author(s):  
Noor Ayesha Begum ◽  
Lokesh Chandra H. C. ◽  
Ravindra S. Pukale

Background: Abnormal uterine bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Most frequently used diagnostics tests to investigate the causes of abnormal bleeding are Transvaginal ultrasonography (TVS) and endometrial biopsy. Uterine curettage is an invasive procedure and is performed with anaesthesia. TVS is a non-invasive method that has been used to evaluate the endometrium and uterine cavity. The objectives of this study were to measure and evaluate the role and accuracy of endometrial thickness by transvaginal ultrasonography study to detect endometrial pathology in perimenopausal women presenting with Abnormal Uterine Bleeding. To correlate the transvaginal sonographic results with the Histopathological findings to discriminate normal from pathological endometrium.Methods: Prospective study including 150 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TVS and then D and C was performed for all the patients.Results: Out of 150 women, 128 (85.3%) had normal and 22 (15%) had an abnormal endometrium. 43.3% were of 41-45 years and 65.3% patients presented with complaint of heavy menstrual bleeding. Majority of the patients in the study group were para 2 or more. Fibroid uterus (24%) was the commonest uterine pathology detected on TVS. 53.3% of patients had endometrial thickness in the range 10-14.9 mm. Most common finding on HPE was secretory endometrium (44.6%). Endometrial carcinoma was found in 3%. Endometrial thickness <14mm was associated with least abnormal endometrial pathology.Conclusions: Endometrial thickness of less than 14 mm need not be indicated for D and C in perimenopausal abnormal uterine bleeding. In perimenopausal women with AUB, TVS should be the investigation of choice due to its convenience, accuracy and non- invasiveness.


2005 ◽  
Vol 2 (1) ◽  
pp. 51-55 ◽  
Author(s):  
I. Stamatellos ◽  
P. Stamatopoulos ◽  
D. Rousso ◽  
E. Asimakopoulos ◽  
C. Stamatopoulos ◽  
...  

2020 ◽  
Vol 15 (1) ◽  
pp. 50-54
Author(s):  
Sapna Chauhan ◽  
Krishnapriya Radhakrishnan

Aims: To study the association of clinical profile of patients with Abnormal Uterine Bleeding with the different endometrial histopathological patterns Methods: A retrospective cross-sectional study was done in the department of Obstetrics and Gynaecology at a hospital in Karnataka, India from January 2017 to January 2019. Medical records were reviewed for all the cases of abnormal uterine bleeding who underwent endometrial biopsy. Results: There were 148 records of endometrial biopsies; >55% were in 41-50 years age group; 28% had postmenopausal bleeding; and 28% presented with menorrhagia. Menorrhagia and menometrorrhagia were equally common under 50 years of age. The various physiological patterns of endometrium (proliferative, secretory & menstruating endometrium) were noted in more than half the cases (51%). Proliferative endometrium was in 37%, followed by hyperplasia without atypia in 22% and only 3% showed malignancy; all of whom were in the postmenopausal group. Even in women with post menopausal bleeding, proliferative pattern was the commonest (33%), followed by atrophic endometrium and malignancy. Atypical hyperplasia was found to be most commonly associated with post menopausal bleeding. Conclusions: Both physiological and non physiological endometrial patterns were seen almost equally among the AUB cases. The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 yrs; i.e, the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest. Key words: abnormal uterine bleeding, endometrial cancer, endometrial sampling, hyperplasia


2021 ◽  
pp. 29-32
Author(s):  
Zothansung Joute ◽  
Telen Thangkhojam Kom ◽  
Phirthangmoi Fimate ◽  
Rajesh Singh Laishram

Objective: To assess the diagnostic accuracy of preoperative curettage biopsy samples and to correlate the ndings with post hysterectomy curettage samples for different endometrial pathologies. Methods: This cross-sectional study was conducted from October 2012 to September 2014 in the Department of Pathology in collaboration with the Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur. Approval from institutional ethical committee was taken before starting the study. Specimens of all perimenopausal women with abnormal uterine bleeding (AUB) who underwent endometrial biopsy and subsequent hysterectomy were studied in the Department of Pathology. Results: A total of 50 cases of clinically diagnosed patients with abnormal uterine bleeding were studied. Preoperative Endometrial curettage biopsy was followed By curettage post-hysterectomy. Biopsy ndings were correlated with post-hysterectomy curettage ndings. The age group of the patients range from 37 years to 53 years with maximum number of cases in the range of 45 to 50 years (38%). Proliferative endometrium was the most common pattern (56%) obtained by endometrial curettage biopsy as well as in post hysterectomy curettage followed by secretory endometrium. Statistical analysis of endometrial biopsy study of 48 cases showed that it has a high Sensitivity (100%), Negative predicted value (100%), Specicity (97.44%) and Positive predicted value (90.91%). The Accuracy of the test was 98%. Conclusions: While endometrial curettage biopsy using uterine curette is not the gold standard for diagnosing endometrial pathologies in AUB, it is an important diagnostic tool in the investigation for assessment of endometrium as it has few advantages.


1970 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
R Baral ◽  
S Pudasaini

Background: Histological characteristics of endometrial biopsy material as assessed by light microscopy remain the diagnostic standard for the clinical diagnosis of endometrial pathology. Management of abnormal uterine bleeding is not complete without tissue diagnosis. The aim of the study was to find out the histopathological pattern of the endometrium in abnormal uterine bleeding. Materials and Methods: Endometrial biopsy specimens received from Jan 2007 to Nov 2010 were studied retrospectively in the Department of Histopathology, Helping Hands Community Hospital, Kathmandu. The specimens were routinely processed and the hematoxyllin and eosin stained slides were studied. Results: A total of 300 specimens were analyzed. In the group of patients less than 40 years of age, 73 (50%) were normal, 34(23%) had abnormal physiologic changes and 13 (9%) had pregnancy related complications and benign changes. In the age group between 40 – 55 years, abnormal physiological changes, benign conditions and normal physiological changes were 45 (32%), 41 (29%) and 37 (26%) respectively. In the age group > 55 years, there were 3(21%) malignant and 3(21%) benign conditions. There were 5(36%) unsatisfactory samples in this age group. Conclusion: It is important to know the histological pattern of the endometrium in abnormal uterine bleeding in different age groups since it will help in the management of the cases. In this study endometrial hyperplasias were seen in 55 cases (18.8%). The importance of studying the histological pattern of endometrium in abnormal uterine bleeding in different age group is to help in correctly managing the cases. Keywords: Endometrium; Simple hyperplasia; Complex hyperplasia; Endometritis; Endometrial Carcinoma. DOI: 10.3126/jpn.v1i1.4443 Journal of Pathology of Nepal (2011) Vol.1, 13-16


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