A COMPARATIVE STUDY OF PREOPERATIVE ENDOMETRIAL BIOPSY AND ENDOMETRIAL CURETTAGE FROM HYSTERECTOMY SPECIMEN IN PERIMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
pp. 29-32
Author(s):  
Zothansung Joute ◽  
Telen Thangkhojam Kom ◽  
Phirthangmoi Fimate ◽  
Rajesh Singh Laishram
Keyword(s):  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Positive Predicted Value ◽  
Perimenopausal Women ◽  
Important Diagnostic Tool ◽  
Proliferative Endometrium

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.

scholarly journals Transvaginal Ultrasonography and Hysteroscopy in Evaluation of Abnormal Uterine Bleeding- A Cross-sectional Study

2021 ◽  
Author(s):  
G Sindhujha Sekar ◽  
A Esther Ruby ◽  
P Lalitha
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional

Introduction: In perimenopausal age group particularly, 70% of all gynaecological consultations are for Abnormal Uterine Bleeding (AUB). About 30% of women seek medical assistance for AUB during their reproductive age group and about one third of hysterectomies are carried out for AUB alone. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of Transvaginal Ultrasonography (TVS) versus hysteroscopy in detecting uterine abnormalities Materials and Methods: A cross-sectional study in patients with AUB, admitted to the Department of Obstetrics and Gynaecology at RGGWCH, Puducherry between February 2016 and February 2017 who met the inclusion criteria were included. Sample size was 85 cases. After taking detailed history and physical examination the patient was investigated to rule out organic causes of AUB and then TVS and hysteroscopy were done. Any intrauterine pathology was looked for and endometrial sampling was taken from the abnormal sites for Histopathological Examination (HPE). Both TVS and hysteroscopy results were compared with histopathology which is the gold standard. Results: The sensitivity of TVS in diagnosis of uterine fibroid in comparison to hysteroscopy was 94.74% and the specificity was 71.21%. The sensitivity of hysteroscopy in diagnosis of endometrial hyperplasia in comparison to HPE was 75% and the specificity was 87.01%. The sensitivity of TVS in diagnosis of endometrial hyperplasia in comparison to HPE was 37.5% and the specificity was 90.91%. The sensitivity of hysteroscopy in diagnosis of polyp in comparison to HPE was 100% and the specificity was 97.3%. The sensitivity and specificity of TVS in diagnosis of polyp in comparison to HPE were 9.09% and 93.24%, respectively. Conclusion: TVS had a high sensitivity to detect fibroids but its value in detecting hyperplasia and polyps was in question in this study. But hysteroscopy had a maximum sensitivity to detect polyps and high sensitivity to detect endometrial hyperplasia compared to histopathology which is a gold standard investigation.

scholarly journals Benign Histopathologic Findings of Endometrium among Perimenopausal Women presenting with Abnormal Uterine Bleeding: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1141-1145
Author(s):  
Ramesh Dhakhwa ◽  
Rashmi Bhattarai ◽  
Jayanti Shah ◽  
Archana Shakya ◽  
Sailesh Pradhan
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Point Estimate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Histopathological Findings ◽  
Perimenopausal Women

Introduction: Abnormal uterine bleeding is the most common presenting complaint in the perimenopausal age group. Endometrial biopsy obtained by dilatation and curettage is the preferred modality of investigation to determine the causative pathology of abnormal uterine bleeding. The objective of this study was to find out the prevalence of the benign histopathological findings in perimenopausal women presenting with abnormal uterine bleeding. Methods: This descriptive cross-sectional study was conducted among patients between 1st June 2020 to 30th September 2021. Ethical approval was taken from the Institutional Review Committee of Kathmandu Medical College (reference number: 305202002). Using the convenience sampling method, 96 cases of endometrial biopsies were studied under light microscopy. Data was analyzed using the Statistical Package for the Social Sciences version23.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among the 96 specimens, the prevalence of benign findings was 93 (96.9%) (93-100 at 95% Confidence Interval). Among them, the commonest benign histopathologic spectrum was hormonal imbalance pattern in 40 (41.7%) followed by normal menstrual pattern 35 (36.5%). Five (5.2%) cases showed chronic endometritis. Six (6.2%) cases of endometrial hyperplasia without atypia were identified. Three (3.1%) cases showed endometrial atrophy. Four (4.1%) cases showed endometrial polyp. Conclusions: The prevalence of benign histopathological findings among endometrial biopsies in the study was similar to other studies.

scholarly journals Clinical profile of endometrial histopathological patterns in Abnormal Uterine Bleeding

2020 ◽  
Vol 15 (1) ◽  
pp. 50-54
Author(s):  
Sapna Chauhan ◽  
Krishnapriya Radhakrishnan
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Endometrial Sampling ◽  
Post Menopausal

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

scholarly journals ENDOMETRIAL CARCINOMA

2015 ◽  
Vol 22 (10) ◽  
pp. 1256-1261
Author(s):  
Shazia Majid Khan ◽  
Farhat Yasmeen ◽  
Abida Riaz
Keyword(s):  
Endometrial Carcinoma ◽  
Reproductive Tract ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Endometrial Sampling ◽  
The Mean ◽  
Study Setting

Background: Bleeding from the reproductive tract in women is a naturallyoccurring event, generally the result of menstruation and childbirth, and is not associated with ableeding disorder in most cases. Dysfunctional uterine bleeding is the most common reason forwomen to undergo an interventional gynecologic procedure. The major task of the clinician is toexclude endometrial carcinoma in women and to identify organic pathology in order to manageit effectively. Objective. To determine the incidence of endometrial carcinoma in women withabnormal uterine bleeding. Study Design: Cross sectional study. Setting. Department ofObstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan. Duration of study: Sixmonths (16th February 2013 to 15th August 2013). Material and method: One hundred andsixteen women with complaint of abnormal uterine bleeding, meeting the inclusion criteria wereselected. All the patients were undergone endometrial sampling and assessment of endometrialthickness was done which was confirmed by endometrial biopsy to evaluate endometrialpathologies. The collected data was noted on pre-designed proforma. Results: The mean agewas 42.07 years. According to parity, 56 women (48.2%) have 1-4 parity, 48 women (41.4%)have 5-8 parity and 12 women (10.4%) have 9-14 parity. The mean duration of dysfunctionaluterine bleeding was 14.64±7.87 months. Six women (5.2%) have endometrial carcinoma while110 women (94.8%) have no endometrial carcinoma. Conclusion: This study thus proved thatin our setup the incidence of endometrial carcinoma is very high. So every patient with abnormaluterine bleeding should undergo endometrial biopsy to rule out endometrial carcinoma.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals Histopathological evaluation of endometrial sampling in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (8) ◽  
pp. 3180
Author(s):  
Bhavani L. Nair ◽  
Lency S. Kuriakose
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Endometrial Sampling ◽  
Medical College ◽  
Perimenopausal Women ◽  
Proliferative Endometrium ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the common symptoms in the gynaecology outpatient department. About one third of women are affected at some time in their lives. The perimenopausal women show significant number of underlying organic pathology. The evaluation of endometrium and/or organ histopathology has the dual advantage of finding the cause of AUB and to rule out endometrial cancer or the potential for cancer in future like endometrial hyperplasia with atypia. The aim of the study was to determine the histopathological pattern of endometrial sampling in perimenopausal women with AUB and to follow them up for a period of six months after the procedure.Methods: The prospective observational study was conducted at the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, Kerala, for a period of one year from December 2019 to December 2020. The study was conducted on 116 perimenopausal women 41-52 years who presented with AUB and had undergone endometrial sampling. These ladies were subsequently followed up for six months post procedure to assess the response to medical treatment or the need for any surgical intervention like hysterectomy.Results: A total 39.65% patients had heavy and prolonged menstrual bleeding and 18.16% patients had irregular bleeding. 14.65% patients had prolonged flow, 8.6% had heavy flow, 6.8% had infrequent with prolonged flow, 6% had prolonged, infrequent with heavy bleeding. Non-structural (COEIN) causes contributed to about 60.4% of AUB in perimenopausal women and 39.6% had structural (PALM) causes. 49% cases were secretory endometrium. 29.3% had disordered proliferative endometrium, 4.3% had proliferative endometrium, 5.2% each had polyp or hyperplasia without atypia. 18 (15.5%) cases underwent hysterectomy, 3 patients who had adenocarcinoma underwent staging laparotomy, 2 patients had LNG IUS insertion and 40 patients were on follow up requiring either no treatment and 53 (45.68%) patients were given antifibrinolytics or hormonal therapy.Conclusions: Heavy and prolonged menstrual bleeding was the most common presenting symptom. COEIN contributed to about 60.4% of cases. Evaluation of the endometrium showed that, secretory endometrium was commonest (49%) followed by disordered proliferative endometrium (29.3%). On follow up for six months, 15.5% patients underwent hysterectomy, 2 patients had insertion of levonorgestrel IUD, 45.68% patients had medical management with antifibrinolytics or hormones and were on follow up. The responsibility of gynaecologist in the management of AUB in perimenopausal women is to exclude hyperplasia of endometrium and endometrial cancer.

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 Thyroid disorders in women with dysfunctional uterine bleeding

2016 ◽  
Vol 6 (12) ◽  
pp. 1018-1020
Author(s):  
S Subedi ◽  
B Banerjee ◽  
C Manisha
Keyword(s):  
Reproductive Function ◽  
Hormonal Treatment ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Dysfunctional Uterine Bleeding ◽  
Cross Sectional ◽  
Menstrual Pattern

Background: Thyroid hormones play a key role in the menstrual and reproductive function of women .It is recognized universally that menstrual disturbances may accompany clinical alteration in thyroid function and every clinician has encountered altered menstrual pattern among women suffering from thyroid disorders. The aim of this study was to find the incidence of thyroid disorders in Dysfunctional uterine bleeding and its correlation with menstrual patterns.Materials and Methods: A hospital based cross-sectional study including 75 cases with dysfunctional uterine bleeding attending the OPD of Nobel Medical College, where incidence of thyroid disorder was evaluated along with its correlation with menstrual patterns and histopathology.Results: The incidence of Gynecological OPD attendance due to abnormal uterine bleeding was 3%.and the incidence of thyroid dysfunction was 10.6% with hypothyroidism being the commonest. (9.3%). The commonest menstrual pattern found was menorrhagia/polymenorrhoea in 8 percent.Conclusion: Prevalence of hypothyroidism was more common in DUB. Thus every woman with menstrual irregularities should undergo thyroid assessment and this will ultimately avoid unnecessary intervention like misuse of hormonal treatment and hysterectomy.

scholarly journals Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age

2020 ◽  
Vol 9 (7) ◽  
pp. 2792
Author(s):  
Hema K. R. ◽  
Girish B. L. ◽  
Dhananjaya B. S. ◽  
Riyaj Ahmad Kalaburgi
Keyword(s):  
Thyroid Dysfunction ◽  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
Thyroid Profile ◽  
Definitive Management

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.

scholarly journals Assessment of thyroid and prolactin levels among the women with abnormal uterine bleeding

2017 ◽  
Vol 6 (6) ◽  
pp. 2547
Author(s):  
Jovita Deepthy John ◽  
Vimala Damodaran ◽  
Shankar Radhakrishnan
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Cross Sectional Study ◽  
High Serum ◽  
Uterine Bleeding ◽  
Serum Prolactin ◽  
Age Group ◽  
Free T4 ◽  
Cross Sectional ◽  
The Mean ◽  
Tsh Levels

Background: Thyroid disorders are 10 times more common in women than men.1 Menstrual disturbances usually accompany clinical alterations in thyroid function and every clinician would have encountered altered menstrual pattern among women suffering from either hypo or hyper thyroidism. A high serum prolactin level can distrurb the follicular maturation and corpus luteum function, and leads to inhibition of normal pulsatile secretion of gonadotrophin-releasing hormone in hypothalamus resulting in anovulation. The aim of the study was to assess the thyroid and the prolactin levels among the women with abnormal uterine bleeding and to evaluate the association between them by comparing with normal females.Methods: A cross sectional study was conducted for a period of one year between Jan 2016 and December 2016 in our institution at the gynaecology OPD. Patients in the age group of 15 to 45 with the complaints of abnormal uterine bleeding and with the ultrasound findings showing normal uterus and ovary were included in the study. Hundred age and sex matched controls without any complaints of abnormal uterine bleeding in the age group of 15 – 45 years were also included in the study. Free T3, Free T4, TSH and prolactin estimation was done by chemiluminescent immunoassay for both the patients and the controls.Results: The mean TSH levels among the cases were much higher than that of the controls and the difference in the levels found to be statistically significant. Similarly, hyperprolactinemia was found in 18 cases when compared to 2 cases in controls and the mean prolactin levels were higher in cases. The serum prolactin levels and the serum TSH levels showed a perfect positive correlation which indicates that as the TSH level increases prolactin levels also increases with the R value >0.5.Conclusions: Early detection of hypothyroidism in such subjects saves the patient from recurrent curettage and at times hysterectomy. The financial implications of screening for prolactin/thyroid hormone abnormalities will have to be evaluated before a general recommendation can be made.

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