Abnormal uterine bleeding in perimenopausal women: Correlation with sonographic findings and histopathological examination of hysterectomy specimens

Abstract

Background:Abnormal uterine bleeding (AUB) is a frequently encountered gynecologic complaint in perimenopausal woman and also the most common cause of hysterectomy in this age group.Objective:Evaluation of various clinical presentations of perimenopausal AUB and it is ultrasonographic and histopathological correlation of hysterectomy specimens.Materials and Methods:This study was carried out in the Department of Obstetrics and Gynaecology among perimenopausal women who underwent hysterectomy for AUB. The clinical presentations, ultrasonographic findings, and histopathological reports of hysterectomy specimen were correlated.Results:Among 103 number of hysterectomized cases for AUB, most of the patients were between 40 and 45 years of age (67.97%) and menorrhagia was the dominant clinical presentation. The majority (45.63%) of cases were diagnosed as fibroid uterus by ultrasonography with 89.13% sensitivity and 89.47% specificity. Histopathological reports of myometrium showed 44.66% fibromyoma, followed by 34.95% of the normal myometrium. Histopathology of endometrium revealed hyperplasia in the most cases (56.31%) where simple typical type was the predominant.Conclusion:Uterine fibroid was the leading cause of AUB and radiological, pathological evaluation correlated well to diagnose fibroid.

A study of thyroid dysfunction in dysfunctional uterine bleeding

“…According to Talukdar et al, the dominant menstrual problem in patients with abnormal uterine bleeding was menorrhagia in 44.44%. 3 In the present study, 57.5% patients had laprosterilization. The theory of increased bleeding is that delivery of hormones from the ovaries to the uterus is impaired.…”

“…It is more common in fourth to fifth decades of life or in perimenopausal age group. 3 In present study, most of the AUB patients were in the age group of 41 to 50 years (42.50%) followed by 31 to 40 years (38.50%). N Bhavani et al observed that most of the AUB patients were in the age group of 41 to 50 years (40%) followed by 31 to 40 years (37%).…”

“…The system based on the acronym PALM COEIN (polyps, adenomyosis, leiomyoma, malignancy and hyperplasia-coagulopathy, ovulatory disorders, endometrial causes, iatrogenic, not classified) was developed in response to concerns about the design and interpretation of basic science and clinical investigation that relates to the problem of AUB. 3 Dysfunctional uterine bleeding is one of the most common and significant gynaecological complaints and is seen in about 10-15% of women attending the gynaecological clinic.…”

Clinico-Pathological Correlation of Hysterectomy Specimens for Abnormal Uterine Bleeding in Peri Menopausal Women

“…Majority of the cases of peri menopausal uterine bleeding was in age group of 45 -55 years (61 % ).In a similar study by Yogesh Neena et al , maximum cases (54.16 %) were in 45 -55 years (8) . In study by Talukdar B et al, 67.97% of patients were in in age group of 45 -55 years (9) . Thus age group of 45 -55 seems to be most vulnerable age group for uterine bleeding in peri menopausal women.…”

Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

“…So, perimenopausal women with heavy or irregular menstrual bleeding are often advised to have an endometrial sample taken to exclude endometrial disease. 21 Degenerative process of corpus luteum is sluggish in irregular shedding of the endometrium which leads to prolonged menstrual cycle to the waning effect of progesterone seen in 1.4% of cases. The exact cause of bleeding in atrophic endometrium is not known it is thought to be due to anatomic vascular variation or defective local haemostatic mechanism.…”