A PROSPECTIVE ANALYTICAL STUDY OF PATIENTS WITH DYSFUNTIONAL UTERINE BLEEDING.

2021 ◽  
pp. 1-2
Author(s):  
Mangal Supe ◽  
Anup Arun Gundecha

Background: Dysfunctional uterine bleeding is dened as abnormal uterine bleeding not caused by any pelvic pathology, medications, pregnancy related complications or any systemic disease. It is the most common cause of abnormal uterine bleeding. It affects pubertal adolescents and perimenopausal women and is associated with considerable morbidity and affects patient’s family, personal and social life. Patient presents as menorrhagia, polymenorrhea, metrorrhagia or intermenstrual bleeding. It has great variations in endometrial patterns each deciding treatment modality. Objective: To determine frequency of various types of abnormal uterine bleeding and analyze the histopathology of endometrial curettage samples. Method: A prospective analytical study was conducted from Jan 2018 to Dec 2019 on sample of 650 patients between 20-70 years of age with symptoms of dysfunctional uterine bleeding presenting to medical college and hospital, Pimpri. Their endometrial samples were obtained by dilatation and curettage. To have a broader analysis the endometrial histopathology on hysterectomy specimens where the clinical diagnosis was DUB were also included in the study. Data obtained was tabulated and analyzed. Conclusion: The age group 31-40 and 41-50 years was the most common age group presenting with DUB. The predominant pattern of presentation was menorrhagia. The most common endometrial pattern on histopathology was proliferative type.

Author(s):  
A. Shantha ◽  
Nazia Hussain

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.


Author(s):  
L. Thulasi Devi ◽  
Ravi Nimonkar

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.


2014 ◽  
Vol 4 (8) ◽  
pp. 635-638
Author(s):  
N Katuwal ◽  
G Gurung ◽  
A Rana ◽  
A Jha

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


Author(s):  
Dr. Yogesh C. Parmar

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


Author(s):  
Malarvizhi Loganathan ◽  
Meera Krishnakumar

Background: This study was undertaken to study the endometrial histology in patients presenting with abnormal uterine bleeding in the absence of palpable pelvic pathology, which helps in choosing the right modality of treatment in a particular age group with a specific histological change. The study of endometrium in dysfunctional uterine bleeding was undertaken to correlate clinical presentations with histopathological studies and to correlate the distribution of histopathological findings in various age groups.Methods: The present study was conducted in the Department of Obstetrics and Gynaecology at Govt. Dharmapuri Medical College and Hospital during the period 01.07.2017 to 31.05.2018. Patients presenting to Govt. Dharmapuri Medical College and Hospital with abnormal uterine bleeding form the material of this study. Cases have been selected by using purposive sampling technique.Results: An ovulatory cycles were more common than ovulatory cycles in all age group. However, in patients with menorrhagia and polymenorrhagia majority had secretory endometrium (ovulatory cycles).Conclusions: Majority of the patients were found in the reproduction age group with the maximum percentage in multiparous women. Menorrhagia was the commonest mode of presentation in all age group. Most of the patients with proliferative and secretory endometrium had normal sized uterus and normal looking endometrium.


2019 ◽  
Vol 17 (2) ◽  
pp. 52-54
Author(s):  
Durga BC ◽  
Nirmala Sharma

Abnormal uterine bleeding is the third most common clinical presentation in gynecology OPD. Histopathological evaluation of the endometrial tissue plays a significant role in diagnosis and management of Abnormal Uterine Bleeding. Aim: To find out cause of abnormal uterine bleeding with the help of histopathological report of endometrial biopsy. Methodology: This is retrospective observational study done at NGMC from ( 1st June 2018 to -30th June 2019) of 100 patients endometrial biopsy sent for histopathological evaluation and diagnosis reports were correlated with age and bleeding pattern and patients were managed accordingly. Result: A total of 100 endometrial specimens submitted with clinical diagnosis of Abnormal Uterine Bleeding were studied. Patients age group ranged from 18 – 65 yrs and most of them were seen in the age group of 41–50 yrs (43%).The commonest complaint was menorrhagia i.e. 48% .The commonest endometrial pattern observed in the study was, proliferative phase endometrium (38%). Conclusion: Endometrial biopsy is one of the most useful diagnostic tools to find out cause of uterine bleeding in AUB cases and also helps in management of AUB patient.  


Author(s):  
Anitha S. ◽  
Pooja G. ◽  
Sowmya D.

Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out- patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. And also, to observe the incidence of various endometrial pathology in different age groups presenting with abnormal uterine bleeding.Methods: A one-year prospective study conducted in the department of obstetrics and gynaecologist in A. J. institute of medical sciences and research centre which included 200 cases of clinically diagnosed AUB patients. Histopathological examination of endometrial biopsies specimens was done, followed by clinical correlation.Results: The most common age group presenting with AUB was 41-50 years (43.84%). The commonest pattern in these patients was normal cycling endometrium (42.32%). The commonest pathology irrespective of the age group was disordered proliferative pattern (26.15%). Other causes identified atrophic endometrium (11.5%), benign endometrial polyp (5.38%), endometrial hyperplasia (5.41%), carcinomas (0.79%) and chronic endometritis (1.54%).Conclusions: 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 years; i.e., the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest.


Author(s):  
Smriti S. Dwivedi ◽  
Malay Bajpai ◽  
Indu Bhushan ◽  
Arunima Satkirti

Background: Abnormal uterine bleeding is one of the common gynecological complaints of women of all age groups. Histopathological study of endometrial biopsy and curettage samples is an effective diagnostic modality that can be used to identify cause of AUB at its earliest. This study was done to investigate the various endometrial causes of AUB that frequently come to our hospital and their incidence in various age groups i.e. reproductive, perimenopausal and postmenopausal.Methods: This study was conducted on 108 patients who clinically presented with AUB and had their endometrial biopsy and curettage specimens sent to the histopathology department of our tertiary care hospital and teaching centre, located in Uttar Pradesh from June 2018 to May 2019. The endometrial patterns were observed, and their frequencies and percentages were computed and classified age group wise.Results: These studies included patients with age range from 19 to 77 years. The predominant age group with AUB was reproductive age group (<40 years). The most common histopathological finding in this study was normal menstrual pattern (48.15 %). The endometrial pathologies observed were hormonal imbalance and pill effect (22.22%), atrophic endometrium (10.19%), chronic endometritis (5.56%), benign endometrial polyp (4.63%), gestation products (3.70%), endometrial hyperplasia (3.70%), and endometrial carcinoma (1.85%). Conclusion: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.Conclusions: The most commonly known cause of AUB in reproductive age group is due to hormonal imbalance. Endometrial hyperplasia and carcinoma are usually more common in the perimenopausal and postmenopausal age groups. Overall, in patients with no organic cause of AUB, normal cyclical endometrial pattern is the most prevalent endometrial pattern observed.


Author(s):  
Koduru Mounika

Aim: The purpose of the study was to detect thyroid dysfunction in women who had abnormal uterine bleeding Study Design: Menorrhagia was the most common type of bleeding (36%). Thyroid dysfunction was discovered in 32% of the patients (Subclinical hypothyroidism in 17%, Hyper thyroid is 11% and hyperthyroidism in 4 % of cases). The researchers looked at 100 cases of Dysfunctional Uterine Bleeding that were clinically identified at Sree Balaji Medical College and Hospital between March 2014 and August 2016. The patients in this study ranged in age from under 20 to 45 years old. The number of instances with DUB who were between the ages of 31 and 40 is 38 %. Methodology: The parity of the patients ranged from unmarried to 0-5, with the parity 2 group accounting for 37% of all DUB patients and the following assessments were made. Results: Thyroid dysfunction was most common in cases of polymenorrhagia (42.8%), menorrhagia (33.3%), polymenorrhea (28.5%), and oligomenorrhea. (26%). Thyroid dysfunction was most common in the age group 31-40 years, accounting for 77.5% of the population. In 17 % of cases, the primary thyroid malfunction was subclinical hypothyroidism. 3% of hyperthyroid patients were also oligomenorrhocic. The most prevalent thyroid disorder in metrorrhagic patients was subclinical hypothyroidism.


Author(s):  
Chaithra M. ◽  
Anitha G. S. ◽  
Savitha C.

Background: Dysfunctional uterine bleeding is abnormal uterine bleeding in the absence of any palpable pelvic pathology and demonstrable extra genital causes. Thyroid dysfunction is the systemic disease most often associated with abnormal uterine bleeding. Aim was to evaluate thyroid function test in women with DUB; to assess bleeding pattern in thyroid dysfunction.Methods: Prospective observational study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from august 2018 to July 2019. Pre structured and predesigned proforma filled. All routine blood investigations including serum T3, T4, TSH, USG were advised. These patients were categorized as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid based on thyroid profile.Results: 0.5% belonged to the age group of 31-40 years, prevalence of subclinical hypothyroidism is 11%, there were 5.5% of cases of hypothyroidism and 1.5% case of hyperthyroidism.Conclusions: Thyroid screening must be done mandatory for all the cases of DUB and prompt response to treatment with thyroxine would avoid unnecessary surgeries, hormonal treatment, and associated comorbities.


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