ABSTRACT… Objectives: To find out the significance of the transvaginal sonography (TVS) in postmenopausal women (PMW) with postmenopausal bleeding (PMB) and compare it with the histopathological diagnosis at curettage, so that unnecessary operations could be avoided. Study Design: Descriptive study. Setting: Radiological Department for TVS and H/P at the Department of Gynecology & Obstetrics (Gynae: Unit IV) at Liaquat University Medical, Health Sciences Hospital Jamshoro and Hyderabad. Period: September 2010 to September 2011. Material and Methods: The present study was conducted on patients with postmenopausal bleeding. Results: The mean age + SD of the women was 51 + 3.1 years, ranging from a minimum of 49 to 55 years. The mean endometrial thickness was from 1.8-15mm. Transvaginal Sonography and Histopathological Findings: Histopathological findings revealed endometrial atrophy in 64 (57.14%) patients, Endometrial hyperplasia in 24(21.4%), endometrial polyp in 7(6.25%), Endometrial carcinoma in 8 (7.14%), Pyometra in 5(4.46%) and Fibroid uterus in 4(3.57%). With a cut off value of 4mm endometrial thickness, TVS showed a sensitivity of 100%, specificity of 73.33%, a positive predictive value of 76.47%, a negative predictive value 100% and an accuracy of 85.71%. At a cut off limit of 5mm endometrial thickness (endometrium >5mm indicating pathology), the sensitivity of the present study was 92.3% and the specificity was 86.6 %. The positive predictive value was 85.71%, the negative predictive value was 92.86 % and the accuracy was 89 %. Conclusion: TVS is a useful tool to triage post menopausal women with bleeding and avoid un convenient invasive procedure.
Objective: In patients with prelabor membrane rupture at term, evaluate the relative effectiveness of vaginal prostaglandin E2 and oxytocin infusion for induction of labour. Study design: Randomized clinical trial Place and Duration: This study was conducted in the multi centers at the Department of Obstetrics and Gynaecology, Murshid Hospital and Health Care Center Karachi, Sindh and PGMI/AMC/LGH Lahore, Punjab in the period from March, 2022 to August, 2022. Material and methods: Ninety patients with term membrane rupture who were brought through emergency for induction of labour were randomly assigned to either group I (oxytocin) or group II (vaginal prostaglandin E2) and monitored until delivery. We recorded the number of vaginal births that occurred within 24 hours of the induction of labour and the time it took for labour to begin after the induction. All of the data was analyzed with SPSS 23.0. Results: Mean age of the patients in group I was 26.5±6.26 years and in group II mean age was 24.7±5.60. Mean BMI in group I was 25.1±8.16 kg/m2 and in group II mean BMI was 26.1±7.36 kg/m2. Those who were induced with intravenous oxytocin had 22 (48.9%) vaginal deliveries within 24 hours, while patients who were induced with vaginal PGE2 had 32 (71%) vaginal deliveries within 24 hours. Conclusion: The findings of this study led us to the conclusion that vaginally administered PGE2 causes more patients to deliver their babies vaginally within twenty-four hours. Keywords: Oxytocin, Induction of labor, Rupture of membranes, PGE2
Objectives: To find out the significance of the transvaginal sonography (TVS)in postmenopausal women (PMW) with postmenopausal bleeding (PMB) and compare it withthe histopathological diagnosis at curettage, so that unnecessary operations could be avoided.Study Design: Descriptive study. Setting: Radiological Department for TVS and H/P at theDepartment of Gynecology & Obstetrics (Gynae: Unit IV) at Liaquat University Medical, HealthSciences Hospital Jamshoro and Hyderabad. Period: September 2010 to September 2011.Material and Methods: The present study was conducted on patients with postmenopausalbleeding. Results: The mean age + SD of the women was 51 + 3.1 years, ranging from aminimum of 49 to 55 years. The mean endometrial thickness was from 1.8-15mm. TransvaginalSonography and Histopathological Findings: Histopathological findings revealed endometrialatrophy in 64 (57.14%) patients, Endometrial hyperplasia in 24(21.4%), endometrial polyp in7(6.25%), Endometrial carcinoma in 8 (7.14%), Pyometra in 5(4.46%) and Fibroid uterus in4(3.57%). With a cut off value of 4mm endometrial thickness, TVS showed a sensitivity of 100%,specificity of 73.33%, a positive predictive value of 76.47%, a negative predictive value 100%and an accuracy of 85.71%. At a cut off limit of 5mm endometrial thickness (endometrium>5mm indicating pathology), the sensitivity of the present study was 92.3% and the specificitywas 86.6 %. The positive predictive value was 85.71%, the negative predictive value was 92.86% and the accuracy was 89 %. Conclusion: TVS is a useful tool to triage post menopausalwomen with bleeding and avoid un convenient invasive procedure.
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