scholarly journals An incidental case of uterus didelphys and fibroids: Right sided myomectomy and left hemi-hysterectomy

2020 ◽  
Vol 9 (2) ◽  
pp. 1762-1764
Author(s):  
J.N. Mashala ◽  
D. Wekesa ◽  
R. Chemwey ◽  
A. Pulei ◽  
A. Kihara
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Lack Of Fusion ◽  
Uterine Myomas ◽  
Uterus Didelphys ◽  
Vaginal Deliveries ◽  
Mullerian Ducts ◽  
History Of ◽  
Asymptomatic Women ◽  
Intramural Fibroids

Congenital anomalies of the uterus occur due to agenesis or lack of fusion of the Mullerian ducts. The incidence of these anomalies is largely  unknown since they are unlikely to be diagnosed in asymptomatic women. Uterine didelphys or double uterus occurs when the two Mullerian ducts  fail to fuse resulting in duplication of the uterus and cervix. This report discusses a case of a 38-yearold woman who had presented with a longstanding history of abnormal uterine bleeding and cyclical pain. She had had two successful vaginal deliveries prior to presentation to our unit. Sonographic findings revealed large uterine myomas and was consented for open myomectomy. Intraoperatively she was found to have two uteri, both of which had intramural fibroids and two cervices. Keywords: didelphys uterus, fibroid.

Comparison of hydrosonography and transvaginal ultrasonography in the detection of intracavitary pathologies in women with abnormal uterine bleeding

2004 ◽  
Vol 14 (1) ◽  
pp. 57-63 ◽  
Author(s):  
M. A. Guven ◽  
T. Bese ◽  
F. Demirkiran
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Normal Endometrium ◽  
Pathologic Findings ◽  
History Of ◽  
Sensitivity Specificity

BackgroundThe aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding.Study designProspective, randomized, and unblinded study.Material and methodsA total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 ± 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure.ResultsThe surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results.ConclusionHydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.

scholarly journals Failure of intrauterine contraception in a multigravida lady with an undiagnosed uterus didelphys: a case report

2020 ◽  
Vol 10 (1) ◽  
pp. 397
Author(s):  
Shreemanti Bhattacharyya ◽  
Partha S. Sarkar
Keyword(s):  
Uterine Horn ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Uterus Didelphys ◽  
Intrauterine Contraception ◽  
Vaginal Deliveries ◽  
Uterine Anomalies ◽  
Intrauterine Contraceptive ◽  
History Of ◽  
Uterine Malformations

Uterus didelphys remains one of the rarest uterine anomalies partly because; majority women experience no symptoms with an uneventful reproductive life. Despite the cost-effectiveness and efficacy paired with fewer side effects and convenience of using an intrauterine contraceptive device, it is most likely to prove futile in an unsuspected case of didelphic uterus resulting in an unintended pregnancy. Hence, intrauterine contraception is generally considered a contraindication in cases of uterine malformations. We present a case of a multigravida mother (G7 P3 L3 A3) with a history of three term vaginal deliveries, with an undiagnosed uterus didelphys, carrying a single live intrauterine pregnancy of approximately 6 weeks period of gestation, in the right uterine horn and a copper containing intrauterine contraceptive device in the left uterine horn, willing to undergo medical termination of pregnancy. A high index of suspicion, on the part of the gynaecologist as well as the radiologist, is required to investigate concurrent pregnancy with a history of an intrauterine contraceptive device insertion, in order to rule out rarer uterine malformations like uterus didelphys. Thorough history taking and clinical examination accompanied by improved imaging techniques should be performed at the time of first pregnancy in order to avoid an unsuitable placement of an intrauterine contraceptive device.

scholarly journals ECTOPIC PREGNANCY : A MAJOR CAUSE OF MATERNAL MORTALITY?

2003 ◽  
Vol 42 (147) ◽  
pp. 151-155
Author(s):  
Rajshree Jha ◽  
M Singh ◽  
A Rana ◽  
A Singh ◽  
S Bastola
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Pelvic Surgery ◽  
Transvaginal Sonography ◽  
Pregnancy Risk ◽  
Abdominal Tenderness ◽  
Presenting Symptoms ◽  
History Of

ABSTRACTSeventyeight cases of ectopic pregnancy were studied retrospectively at Tribhuvan University TeachingHospital during April 1993 - December 1996. The overall incidence of etopic pregnancy was 0.86% livebirths. Grandmultipara were found to be at a low risk for ectopic pregnancy. A history of infertility andprevious pelvic surgery were positive risk factors. The most common presenting symptoms were abdominalpain (90%), history of amenorrhoea (46%), abnormal uterine bleeding (40%). On examination adenexaltenderness (72%), abdominal tenderness (68%), pallor (53%) and cervical excitation (33%) were the mostfrequent findings. Adenexal mass was noted in 22% cases and in 35 % cases the size of the uterus could notbe assessed. Ultrasonography and transvaginal sonography proved to be valuable diagnostic aids. Twomaternal deaths (2.6 %) due to ectopic pregnancy occurred in the hospital during this period.Key Words: Ectopic pregnancy, risk factors, sonography.

scholarly journals Clinical Factors Associated With Anxiety and Depression in Korean Women With Abnormal Uterine Bleeding

2020 ◽  
Author(s):  
Hae Nam Lee ◽  
Ji Min Seo ◽  
Gi Soo Um ◽  
Min Jeong Kim
Keyword(s):  
Depressive Disorders ◽  
Health Management ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
University Hospital ◽  
Menstrual Bleeding ◽  
Anxiety And Depression ◽  
Korean Women ◽  
History Of

Abstract Background: Abnormal uterine bleeding (AUB) is defined as an abnormality in menstrual bleeding and is common gynecological problem in premenopausal women. Anxiety and depressive disorders were frequently observed in patients with AUB. This study was conducted to investigate the prevalence and the relationship of anxiety and depression in Korean women with AUB.Methods: The study was a questionnaire study of 124 Korean women aged 15–55 who admitted a single university hospital due to AUB between September 2015 and December 2019. Anxiety, depression were assessed using the Korean Beck Anxiety Inventory (K-BAI), the Korean Beck Depression Inventory-II (K-BDI-II). The obstetrical and clinical data were analyzed to assess the association of anxiety and depression with AUB.Results: Out of 124 patients, 47 (37.9%) met the criteria for anxiety, and 24 (19.5%) met the criteria for depression. The most common menstrual problems seen were heavy menstrual bleeding (80.7%), followed by irregular bleeding (62.9%), dysmenorrhea (55.7%), and irregular menstrual cycles (33.9%). More women with AUB in our study had anxiety as measured by the K-BAI and depression as measured by the K-BDI-II. A history of abortion and cesarean section were related with anxiety, whereas a history of minor surgery was related to depression. Anxiety and depression (r = 0.629, p < 0.001) were correlated with AUB.Conclusions: Anxiety and depression are underdiagnosed and undertreated in Korean women with AUB symptoms. Screening and appropriate mental health management are needed for women with AUB for women’s health.

scholarly journals Association of thyroid dysfunction with abnormal uterine bleeding

2018 ◽  
Vol 7 (6) ◽  
pp. 2388
Author(s):  
Lakshmi Manjeera M. ◽  
Prabhneet Kaur
Keyword(s):  
Thyroid Dysfunction ◽  
Endometrial Thickness ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Thyroid Function Tests ◽  
Medical College ◽  
History Of ◽  
Hormonal Steroids ◽  
Thyroid Abnormalities ◽  
Rule Out

Background: Abnormal uterine bleeding is a common complaint for women being referred to the gynaecologist and is associated with an array of symptoms. The objective of this study was to detect association of thyroid dysfunction in patients with menstrual irregularitiesMethods: This non-interventional prospective study was done over a period of one and half years in a private medical college in Mangalore. All patients in age group of 15-55 years who presented with history of menstrual disturbances were enrolled and evaluated in the study. Patients with structural causes of AUB or using IUCDs or hormonal steroids were excluded. Total of 85 patients were hence evaluated. These 85 patients were subjected to routine investigations like Hb, BT, CT and platelets (to rule out coagulation defects) along with TSH, T3, T4 estimation. Ultrasound abdomen and pelvis with endometrial thickness was done to rule out structural causes.Results: The most common menstrual disturbance was menorrhagia (47 patients: 55.3%). Thyroid abnormalities were found in 29 of the 85 patients with AUB (34.11%). Of the 29 patients with thyroid dysfunction, 24 were hypothyroid and 5 patients were found to be hyperthyroid.Conclusions: Thyroid abnormalities are frequently associated with menstrual irregularities. Hence Thyroid Function Tests are extremely valuable in patients with provisional diagnosis of AUB and should be made mandatory to avoid unnecessary hormonal or surgical treatment in such patients.

scholarly journals Abnormal Uterine Bleeding in Adolescent

2021 ◽  
Vol 4 (2s) ◽  
pp. 15-22
Author(s):  
Evelyne Theresia ◽  
◽  
Andreas Christoper ◽  
Melissa Edelweishia
Keyword(s):  
Treatment Options ◽  
Abnormal Uterine Bleeding ◽  
Hemodynamic Instability ◽  
Uterine Bleeding ◽  
Warning Signs ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
History Of ◽  
Flow Treatment

Abstract Abnormal uterine bleeding (AUB) is a frequent cause of visits to health care provider during adolescent period. Heavy menstrual bleeding is the most frequent clinical presentation of AUB. This condition particularly worrisome in this group not only when it occurs at menarche, but also anytime afterward when bleeding lasts longer than 7 days, blood loss is greater than 80 mL per cycle, or other warning signs that indicate a history of heavy bleeding such as anemia. Careful history and examination can help elucidate the best next steps for workup and management. The primary goal of treatment is prevention of hemodynamic instability. Therefore, assessing the severity and cause of bleeding is important. Therapeutic approach in the acute period should be established according to the degree of anemia and amount of flow. Treatment options for medical care of AUB generally include hormonal, nonhormonal and surgery. Additionally, long-term management with hormonal therapy in patients with severe uterine bleeding is known to be safe for developing HPO axis. Keyword: Abnormal uterine bleeding, adolescents, heavy menstrual bleeding

scholarly journals Myomectomy Revisited: Experiences in a Teaching Hospital

2016 ◽  
Vol 54 (202) ◽  
pp. 79-81
Author(s):  
Shanti Subedi ◽  
Manisha Chhetry ◽  
Sabina Lamichhane
Keyword(s):  
Teaching Hospital ◽  
Reproductive Tract ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Presenting Symptoms ◽  
Uterine Myomas ◽  
Common Location

Introduction: Uterine myomas are the most common benign tumors of the female reproductive tract with myomectomy being one of the major modalities of the treatment in our set up. The aim of this study was to share the experiences of open myomectomy from a Teaching Hospital.Methods: A observational study was conducted from a records of myomectomy cases in the department of Obstetrics and Gynaecology at Nobel Medical College teaching Hospital from June 2014- May 2016.Results: Total 38 cases of myomectomy were performed during the study period in the women most commong age group being 35-39 years, followed by 30-34. The most common presenting symptoms was abnormal uterine bleeding in 15 (39.47%) followed by mass per abdomen in 10 (26.31%). The most common location of the myoma was intramural followed by subserosal, submucus. Degeneration was also noted in majority of the cases. All the myomectomies were done with Inj Vasopressin injected paracervically except in one case where tourniquet was used. None of the patients had significant post-operative morbidity except fever in the first 24 hours.Conclusions: Abdominal myomectomy is a safe and effective procedure for uterine myomas for infertile women in the past but it should be offered to those desiring for uterine preservation irrespective of age and reproductive status. Keywords: abnormal uterine bleeding; degeneration; myomectomy. | PubMed

scholarly journals Placental site trophoblastic tumor unprecedented by conception: a very rare presentation

2021 ◽  
Vol 10 (3) ◽  
pp. 1180
Author(s):  
Sanjay Badesara ◽  
Kiran Jakhar
Keyword(s):  
Elevated Serum ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Gestational Trophoblastic Neoplasia ◽  
Placental Site Trophoblastic Tumor ◽  
Rare Presentation ◽  
Trophoblastic Cells ◽  
Placental Site ◽  
History Of ◽  
Β Hcg

Placental site trophoblastic tumour is the rare variant of gestational trophoblastic neoplasia with incidence rate of approximately 1/100,000 of all pregnancies. Histologically it is characterized by intermediate trophoblastic cells with few syntical elements. The index report depict a 20 years old unmarried female with no history of conception presenting with abnormal uterine bleeding and mildly elevated serum β-HCG level. Multi-modality treatment was given and she had fair outcome. 

scholarly journals How to Evaluate Adenomyosis in Patients Affected by Endometriosis?

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Nadine Di Donato ◽  
Renato Seracchioli
Keyword(s):  
Demographic Data ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Ultrasound Diagnosis ◽  
Deep Infiltrating Endometriosis ◽  
Previous Surgery ◽  
Deep Endometriosis ◽  
Question Mark ◽  
History Of ◽  
Infiltrating Endometriosis

Objective. The aim of the study is to evaluate adenomyosis in patients undergoing surgery for different type of endometriosis. It is an observational study including women with preoperative ultrasound diagnosis of adenomyosis. Demographic data and symptoms were recorded (age, body mass index, parity, history of previous surgery, dysmenorrhea, dyspareunia, dyschezia, dysuria, and abnormal uterine bleeding). Moreover a particular endometrial shape “question mark sign” linked to the presence of adenomyosis was assessed.Results. From 217 patients with ultrasound diagnosis of adenomyosis, we found 73 with ovarian histological confirmation of endometriosis, 92 with deep infiltrating endometriosis, and 52 patients who underwent surgery for infertility. Women with adenomyosis alone represented the oldest group of patients (37.8±5.18years,P=0.02). Deep endometriosis patients were nulliparous more frequently (P<0.0001), had history of previous surgery (P=0.004), and complained of more intense pain symptoms than other groups. Adenomyosis alone was significantly associated with abnormal uterine bleeding (P<0.0001). The question mark sign was found to be strongly related to posterior deep infiltrating endometriosis (P=0.01).Conclusion. Our study confirmed the strong relationship between adenomyosis and endometriosis and evaluated demographic aspects and symptoms in patients affected by different type of endometriosis.

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