scholarly journals Perimenopausal women presenting with abnormal uterine bleeding: Endometrial thickness

2021 ◽  
Vol 5 (6) ◽  
pp. 98-100
Author(s):  
Dr. Noor Ayesha Begum ◽  
Dr. Anil Kumar GV ◽  
Dr. Lokesh Chandra HC
Keyword(s):  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Perimenopausal Women

scholarly journals Evaluation of endometrial thickness with transvaginal ultrasonography in perimenopausal women presenting with abnormal uterine bleeding and correlation with its histopathological findings

2019 ◽  
Vol 8 (11) ◽  
pp. 4496
Author(s):  
Noor Ayesha Begum ◽  
Lokesh Chandra H. C. ◽  
Ravindra S. Pukale
Keyword(s):  
Endometrial Thickness ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Transvaginal Ultrasonography ◽  
Common Finding ◽  
Histopathological Findings ◽  
Perimenopausal Women

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.

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 Peri- and Postmenopausal Uterine Bleeding Transvaginal Ultrasound with Hysterosonography and Diagnostic Correlation with Hysteroscopy

2011 ◽  
Vol 5 (4) ◽  
pp. 343-352
Author(s):  
Mandakini Parihar ◽  
Anand Parihar
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Medical Science ◽  
Abnormal Uterine Bleeding ◽  
Final Diagnosis ◽  
Uterine Bleeding ◽  
Additional Information ◽  
Final Treatment ◽  
Perimenopausal Women ◽  
Cystic Changes

ABSTRACT The recent years have seen medical science and technology expand by leaps and bounds. We have shifted focus from correction of the problem to prevention of the problem. Abnormal uterine bleeding is an important cause of ill health in perimenopausal women. In the perimenopausal years, there is an increase in the incidence of bleeding irregularities. This is because of an increase in the prevalence of benign and malignant uterine lesions. There has also been a significant increase in the number of women presenting with postmenopausal bleeding. At transvaginal ultrasonography (TVS), the finding of a thickened central endometrial complex, with or without cystic changes, is often nonspecific and may be caused by an endometrial polyp, submucosal fibroid, endometrial hyperplasia, carcinoma or cystic atrophy. In addition, because of an increased prevalence of adenomyosis or adenomyosis-like changes in women around this age group, proper transvaginal sonographic assessment of endometrial thickness and abnormalities is of utmost importance but maybe difficult in some women. When TVS cannot accurately measure the endometrial thickness or when there is a nonspecific thickened central endometrial complex, hysterosonography can provide additional information and can help in the diagnosis and final treatment. Hysterosonography, as an adjunct to TVS, allows identification of intracavitary lesions and focal and diffuse endometrial abnormalities and helps determine the abnormality. Final diagnosis confirmed by hysteroscopy. In this review, we discuss these common abnormalities and the correlation of TVS and hysterosonographic findings with hysteroscopic evaluation.

scholarly journals Study of endometrium by trans-vaginal sonography and it’s correlation with histopathology in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (9) ◽  
pp. 3554
Author(s):  
Vandana R. Saravade ◽  
Shuchi Chaturvedi
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Age Group ◽  
Dilation And Curettage ◽  
Perimenopausal Women ◽  
Multiparous Women ◽  
Vaginal Sonography

Background: Objectives of the study were to study the endometrial patterns in cases of abnormal uterine bleeding (AUB) and anatomical (structural) lesions of uterus using transvaginal sonography (TVS) and endometrial histopathology and to determine the efficacy of TVS.Methods: Cross-section study of 50 perimenopausal age group with AUB in TNMC BYL Nair hospital from Nov 2017 to Nov 2018.Results: AUB was seen 40 to 45 years multiparous women TVS endometrial thickness (ET) T 6-10 mm (46%), ET 11-15 (22%), ET>15 mm (14%), <5 mm in (18%), showed 21 (42%) patients with endometrial hyperplasia on TVS, 12 (24%) simple hyperplasia 4 (8%) complex hyperplasia on histopathology fibroid 8%, adenomyosis 2%. endometrial polyp 6%.Conclusions: Endometrial lining exceeds 10 mm dilation and curettage to be done r/o endometrial hyperplasia, to study the endometrial patterns in cases of abnormal uterine bleeding and anatomical (structural) lesions of uterus using transvaginal sonography and endometrial histopathology.

scholarly journals Endometrial Cut Off Thickness as Predictor of Endometrial Pathology in Perimenopausal Women with Abnormal Uterine Bleeding: A Cross-Sectional Study

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Prity Kumari ◽  
Harsha S. Gaikwad ◽  
Banashree Nath
Keyword(s):  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Endometrial Sampling ◽  
Group I ◽  
Significant Difference ◽  
Perimenopausal Women ◽  
Endometrial Pathology

Purpose. We aim to determine the predictive value of endometrial thickness by transvaginal ultrasonography (TVS) in diagnosing endometrial pathology and to evaluate whether Doppler complements its diagnostic efficacy in perimenopausal women with abnormal uterine bleeding. Methods. This cross-sectional observational study was conducted among 70 perimenopausal women with AUB who underwent TVS measurement of endometrial thickness (ET) and Doppler flow indices followed by endometrial sampling and histopathological examination (HPE). Results. In HPE, 51 (73%) women had normal diagnosis while 19 (27%) women had neoplastic histology either benign or malignant. They were categorised into group I and group II, respectively. There was a significant difference in age ( P = 0.001 ) and incidence of obesity ( P = 0.01 ) between the two groups. The ETs measured in group I and group II were 7.89 ± 2.62 mm and 14.07 ± 3.96 mm, respectively, with significant difference ( P < 0.001 ). A TVS-ET of 10.5 mm had the highest sensitivity and specificity of 89.5% and 86.3%, respectively, PPV of 70.68%, NPV of 95.68%, LR+ of 6.52, and LR− of 0.12. Doppler flow velocimetric study of endometrial and uterine vessels did not demonstrate a significant difference. Conclusions. Women in perimenopause with AUB should be offered to undergo endometrial sampling for histopathological examination if TVS ET ≥10.5 mm. The coexisting risk factors especially higher age (>45 years) and obesity (BMI>30) significantly escalate the chances of developing endometrial pathology.

scholarly journals Abnormal uterine bleeding in perimenopausal women: sonographic and histopathological correlation and evaluation of uterine endometrium

2020 ◽  
Vol 9 (5) ◽  
pp. 1959
Author(s):  
Rupali Modak ◽  
Amitrajit Pal ◽  
Amitava Pal ◽  
Kausik Bose
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Uterine Bleeding ◽  
Teaching Hospitals ◽  
Histopathological Diagnosis ◽  
Eligibility Criteria ◽  
Uterine Endometrium ◽  
Perimenopausal Women

Background: The objectives of the study was to establish the role of histopathological diagnosis of uterine endometrial lesions in patients of AUB at perimenopausal age and to correlate the transvaginal sonographic (TVS) finding with histopathological examination.Methods: This prospective observational study was carried out over 1 and 1/2 years in the two apex level teaching hospitals in eastern India. A total of 197 women in the age group of 40-49 years and ≥50 years (up to 55 years) who presented with abnormal uterine bleeding were included in the study. After selecting the patient with eligibility criteria in the OPD, detailed clinical history, systemic and gynecological examinations and investigations were done as per proforma. TVS study of endometrial pattern and thickness was measured followed by dilatation and curettage (D and C) and HPE of the endometrial curetting was done.Results: Menorrhagia (44.67%) was the most common clinical finding. Mean endometrial thickness measured by TVS was 7.04±2.11 mm in proliferative phase and 10.25±1.27 mm in the secretory phase. Proliferative endometrium (37.06%) was the most frequent finding in HPE followed by secretory endometrium (20.3%). Hyperplasia of endometrium was noted in 27 cases (100%) at 12-15 mm of endometrial thickness on TVS whereas endometrial hyperplasia with and without atypia and endometrial carcinoma was noted in 25 cases (92.59%) at the same thickness of 12-15 mm of uterine endometrium on HPE. Endometrial hyperplasia and polyp both had sensitivity of 84.21% and 71.43% respectively on TVS as compared with histopathology.Conclusions: Increased endometrial thickness and echo pattern by TVS correlated well with abnormal endometrial tissue histopathology in perimenopausal women with AUB.

scholarly journals A descriptive study of Endometrial Biopsies in perimenopausal women having Abnormal uterine bleeding

2021 ◽  
Vol 6 (3) ◽  
pp. 203-205
Author(s):  
Sandhya I ◽  
Manjushree Prabhu P ◽  
Purnima S Rao ◽  
Sameeksha Alwa
Keyword(s):  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Perimenopausal Women ◽  
Pathological Evaluation ◽  
Secretory Endometrium

Abnormal uterine bleeding (AUB) is one of the commonest symptom with which the perimenopausal female visits the gynaecologist accounting for over 70% of all gynecological consultations in that age group. The clinical presentation of AUB can range anywhere menorrhagia, polymenorrhea, polymenorrhagia, metrorrhagia, and menometrorrhagia. Though biopsy is the gold standard it is an invasive procedure and hence often an Ultrasound is used to evaluate the pathology of the endometrium routinely hence, we decided to study the accuracy between radiological ET thickened and its usefulness in detecting endometrial pathology. This study was carried out in the Department of Pathology at AJIMS, Mangalore for a period of 2 years. The sample included endometrial biopies and hysterectomy specimens of perimenopausal women for AUB. The ultrasonographic findings and Histopathological (HPE) reports were analysed. Among 101 cases for AUB, 67 cases were diagnosed as non secretory endometrium. Out of these 67 cases, 49 cases were associated with fibroids. Out of the rest of the AUB cases, 31 of them were diagnosed to have endometrial hyperplasia and 3 cases were diagnosed to have endometrial carcinoma. USG thickness of 17(54%) out of 31 endometrial hyperplasia cases were abnormal. Radiological and pathological evaluation were concordant with diagnosis of AUB associated with fibroids. However only 54% of the endometrial hyperplasia were found to have abnormal endometrial thickness. Radiological evaluation of endometrial thickness is not concordant in 46 % of the cases. This implies that histopathological examination is gold standard diagnostic tool for endometrial abnormalities in perimenopausal women.

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