STUDY OF DIAGNOSTIC HYSTEROSCOPY IN PERI AND POSTMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
pp. 9-12
Author(s):  
Surbhi Sharma ◽  
Kushla Pathania ◽  
Rama Thakur
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
P Value ◽  
Care Hospital ◽  
Prolonged Bleeding ◽  
Menopausal Women ◽  
Post Menopausal

Background:Abnormal uterine bleeding is dened as bleeding from uterus that differs from that of usual normal menstrual bleeding, in frequency of occurrence or in amount or in alteration of ow. The advantages of hysteroscopy as an accurate diagnostic technique are that it not only allows direct visual observation of pathology but also provides a means to sample the site, most likely to yield positive results. The present study was conducted to study the role of Hysteroscopy in abnormal uterine bleeding in Peri and Post-menopausal women at a tertiary care hospital. Material And Methods: Present study was single-center, prospective, Cross sectional study, conducted in women age ≥40years with heavy menstrual bleeding, prolonged bleeding, frequent menstruation, intermenstrual bleeding and post coital bleeding, Post-menopausal bleeding. Hysteroscopy was performed preferably in post-menstrual phase or post bleeding phase with a standard 4mm hysteroscope(Stryker) with a 30 degree fore-oblique lens. Procedure was performed under IV sedation with normal saline as distention media. Results: In present study, majority of the subjects (n=28) i.e. 36.8% presented with heavy menstrual bleeding followed by prolonged bleeding (32.8%), post- menopausal bleeding (21%), frequent menstruation (7.89%) and inter-menstrual bleeding (1.3%). On hysteroscopy normal ndings were present in 32 subjects (42%) followed by hyperplasia (17.1%), atrophic endometrium (13.1%), submucous broid (14.4%), endometrial growth (2.96%) & broid polyp (1.36%). Histopathology examination noted Proliferative endometrium (31.5%), secretory (10.5%), disordered proliferative phase (1.3%), simple hyperplasia (18.4%), complex hyperplasia with atypia (1.3%), submucous broid (14.4%), endometrial polyp (34.2%), atrophy (13.1%), broid polyp (1.34%) and malignancy (3.96%). Sensitivity, Specicity, PPV, NPV values were 100 % except for sensitivity for endometrial growth (66.7 %). p Value was highly signicant for all parameters (p <0.0001) Conclusion: Hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.. The intracavitary lesions (submucous leiomyomas, polyps, endometrial growth are) better diagnosed on hysteroscopy

EVALUATION OF SERUM TSH IN PREMENOPAUSAL AND POST MENOPAUSAL WOMEN IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 30-33
Author(s):  
Elvis Vishal Saurabh Saurabh Dadel ◽  
Tarique Aziz ◽  
Asha Premlata Omega Oraon
Keyword(s):  
Statistical Analysis ◽  
Postmenopausal Women ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Reproductive Age ◽  
P Value ◽  
Care Hospital ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Serum Tsh

Objective- To evaluate and compare the level of TSH in premenopausal women (reproductive age group) and post-menopausal women. Material And Methods- The study was carried out on 100 premenopausal and 100 post-menopausal women attending Out Patient Departments at RIMS, Ranchi, during the period of January 2018- October 2019. Study Design: - Observational Study. Statistics- Statistical analysis was done using SPSS software. The data were represented by counts, percentage and mean ± standard deviation. Statistical analysis of TSH was done by t-test to compare these parameters in premenopausal and post-menopausal women. A p-value of <0.05 was considered statistically signicant. Result- In the present study, we found that the mean serum TSH level in postmenopausal women 2.72 (± 1.06) uIU/ml was comparatively higher than premenopausal women 2.29 (±1.12) uIU/ml and the difference between the two was statistically signicant (p<0.001). Conclusion- Thyroid hormones play an important role in maintaining normal reproductive behaviour by directly effecting on gonadal function and indirectly interacting with sex hormone binding protein. Alteration of thyroid hormone level leads to menstrual irregularities and infertility. The present study clearly demonstrated that there was signicant increase in TSH levels in post-menopausal women and was statistically signicant. Thus, it proved that postmenopausal women are more prone to subclinical hypothyroidism.

scholarly journals Levonorgesterel releasing intra uterine system in the control of heavy menstrual bleeding. Is it an alternative to hysterectomy?

2019 ◽  
Vol 8 (11) ◽  
pp. 4448
Author(s):  
Sobha S. Nair ◽  
Jayashree Nayar ◽  
Ann John Kurien ◽  
Isha Seth
Keyword(s):  
Quality Of Life ◽  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Complete Regression ◽  
Menstrual Symptoms

Background: Heavy menstrual bleeding (HMB) affects 10 to 35% of women. Studies indicate LNG-IUS which releases controlled amounts of levonorgestrel (LNG) is effective in non- surgical treatment for HMB and has fewer side effects when compared to the conventional pharmacological agents. It also improves the quality of life. Levonorgesterel releasing intra uterine system can be an alternative to hysterectomy in the control of HMB.Methods: Retrospective study of 2 years in a tertiary care centre, Kochi. 170 women with abnormal uterine bleeding were enrolled in the study. Clinical examination, routine investigations and imaging was done.  Endometrial sampling done and followed with HPE reports in indicated cases.Results: Mean age was 41 years. 30.6% had menorrhagia. Adenomyosis in 44% and endometrial hyperplasia in 19. 4%. Lost follow up in 12.9% cases and expulsion in 3.6%. 4.1% were unsatisfied and had hysterectomy. The uterine width in adenomyosis was significantly reduced p <0.012. The mean ET in endometrial hyperplasia cases also significantly reduced with p <0.01. Satisfaction rate was 97%.Conclusions: LNG-IUS is having a high success rate in controlling menstrual symptoms, thereby improving the quality of life and avoiding hysterectomy in women with abnormal uterine bleeding. It is highly efficient in symptomatic relief of adenomyosis and reduction in the uterine volume (width). Endometrial hyperplasia showed complete regression with LNG-IUS.

scholarly journals Study of the role of hysteroscopy with dilation and curettage in post- menopausal bleeding: a cross sectional study

2020 ◽  
Vol 9 (5) ◽  
pp. 1954
Author(s):  
Atul Padmawar ◽  
Ankita Khande
Keyword(s):  
Predictive Value ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Cross Sectional ◽  
Dilation And Curettage ◽  
Post Menopausal

Background: Abnormal uterine bleeding is defined as any type of bleeding in which the duration, frequency or amount is excessive for an individual patient. Hysteroscopy has ushered a new era in the evaluation of abnormal uterine bleeding. With this background, we conducted a study to find the role of hysteroscopy with dilation and curettage in post-menopausal bleeding.Methods: It was an observational study conducted in the department of obstetrics and gynecology of a tertiary care hospital in Maharashtra. Post-menopausal patients with abnormal uterine bleeding, admitted in the period of March 2018 to September 2019 were included in the study. A pretested and predesigned questionnaire was used to collect the data. Hysteroscopy with dilation and curettage was done and samples were sent for histopathology.Results: Bleeding was present in all the 30 cases. About 33.33% had pain abdomen, 56.67% had hot flushes, 10.00% had mass and 10% had other symptoms in the present study. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of hysteroscopy in diagnosing malignancy was 75%, 96.15%, 75%, 96.15% and 93.33% respectively.Conclusions: To conclude the most common cause of abnormal uterine bleeding in post-menopausal women in our study was polyp. The sensitivity and specificity of the hysteroscopy in diagnosing the malignant lesions is 75% and 96.15% respectively which corroborated with other study findings. Hysteroscopy with dilation and curettage is better alternative to hysterectomy and biopsy in most of the cases. 

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 Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (10) ◽  
pp. 3885
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Predictive Values ◽  
Menopausal Women ◽  
Submucous Fibroid ◽  
Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

scholarly journals A STUDY OF 70 CASES OF DUB

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Yogesh C. Parmar
Keyword(s):  
Low Socioeconomic Status ◽  
Social Life ◽  
Treatment Options ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Care Hospital ◽  
Dysfunctional Uterine Bleeding ◽  
Medical Disorders ◽  
Number Of Patients

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of dysfunctional  uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders. Methods: A retrospective study of randomly selected 70 cases of dysfunctional  uterine bleeding admitted during October 2006 to September 2007, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital named SSG Hospital at Vadodara. Only cases of AUB due to non-structural causes were included. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months. Results: Most common age group presenting with DUB was 40–50 years  and mostly  belonged to low socioeconomic status. Most of the women were multiparous.  Polymenorrhagia and menorrhagia was most common presentation. Size of uterus is normal in 44 patients. Dilatation and curratage was  having the cure rate of 65.6% .Maximum number of patients (85%) was treated surgically and 15% got medical treatment. Conclusions: Dysfuntional uterine bleeding (DUB) now termed as Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.   Keywords   Menorrhagia, Dysfunctional uterine bleeding,Abnormal uterine bleeding Perimenopausal women, Endometrium

scholarly journals Histopathological evaluation of Endometrium hyperplasia and it’s correlation with the clinical parameters in a tertiary care hospital

2021 ◽  
Vol 6 (3) ◽  
pp. 187-190
Author(s):  
Tina Rai ◽  
Upasana Uniya ◽  
Archana Shrivastava ◽  
G.S Rai
Keyword(s):  
Endometrial Hyperplasia ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Underlying Disease ◽  
Uterine Bleeding ◽  
Clinical Parameters ◽  
Care Hospital ◽  
Age Group ◽  
Proper Management

: Abnormal uterine bleeding is a common clinical presentation in the perimenopausal age group its biopsy serves as an excellent clue to the underlying disease. The presentation may vary according to the type of endometrial hyperplasia and their correlation helps in the proper management of the patients complain.: To analyze the histopathological patterns of endometrial hyperplasia as well as to correlate endometrial hyperplasia with the clinical parameters.: It is a retrospective study and included one year data. A total of 125 cases that underwent hysterectomies or endometrial biopsies for abnormal uterine bleeding were recorded with their clinical history. For all cases the histopathology slides were re-evaluated and results were recorded. Epidemiological variables were analyzed by cross tabulation to assess their relationship. Out of 125 cases 53 cases had endometrial hyperplasia, 24 cases were having simple hyperplasia followed by 14 cases with simple hyperplasia without atypia, 9 cases with complex hyperplasia with atypia followed by 6 cases with complex hyperplasia without atypia. 30 to 50 years age group commonly had endometrial hyperplasia & menorrhagia was the common clinical complain in our patients.: In all the females coming to OPD with abnormal uterine bleeding clinical correlation should be properly made with biopsy report of the patient for the proper management of the condition, which avoids landing up of the patient into further complication.

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