Histopathological correlation of abnormal uterine bleeding in perimenopausal women

Byna, Prasanna; Siddula, Shireesha; Kolli, Swathi; Shaik, Mahaboob Vali

doi:10.18203/2320-1770.ijrcog20151277

Cited by 7 publications

(6 citation statements)

References 1 publication

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“…This will provide less financial burden to the patients rather than opting for whole thyroid function test. Median TSH in our study was found to be 2.12IU/L (1.12-3.60) which is in accordance with study done by Khatiwada, et al 18 in eastern Nepal who found median TSH to be 2 IU/L (1.0-4.0). Brayshaw, et al 19 also reported majority of premenstrual syndrome (35 out of 54 cases) on basis of abnormal TSH test.…”

Section: Discussionsupporting

confidence: 92%

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

Joshi¹,

Rizal²,

Subedi³

2021

J Nepal Med Assoc

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Introduction: Thyroid hormone is known to affect reproductive biology. Abnormal uterine bleeding is one of the common presentations in gynaecology outpatient departments and thyroid dysfunction is known to affect its progression. This study aims to find the prevalence of thyroid dysfunction in diagnosed cases of abnormal uterine bleeding in patients in a tertiary hospital of eastern Nepal. Methods: A descriptive cross-sectional study was conducted in patients diagnosed with abnormal uterine bleeding in a tertiary care hospital of eastern Nepal from April 2019-March 2020 after taking ethical clearance from the Institutional Review Committee. On basis of inclusion and exclusion criteria, 95 cases of abnormal uterine bleeding were included in the study. A blood sample was taken and a thyroid function test was done by chemiluminescence assay on an automated analyzer. Convenient sampling method was used for sample collection. Statistical analysis was done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the total cases of abnormal uterine bleeding, 15 (15.79%) (8.46-23.12 at 95% Confidence Interval) had thyroid dysfunction. Among total cases, 80 (84.21%) were euthyroid. The mean age of the patients was 33±8 years. Among thyroid dysfunction, 9 (60.0%) were hypothyroid, 4 (26.66 %) were subclinical hypothyroid, and 2 (13.33 %) were hyperthyroid. Conclusions: Thyroid dysfunction was common among patients with abnormal uterine bleeding, with hypothyroidism being the most common type.

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Section: Discussionsupporting

confidence: 92%

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

Joshi¹,

Rizal²,

Subedi³

2021

J Nepal Med Assoc

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“…Gorla et al, Khanna et al, Doriaswami et al and Byna et al also reported prolifeartive endometrium as the commonest finding followed by secretory endometrium and disordered proliferative endometrium. 13,[21][22][23] In the present study the occurance of endometrial hyperplasia was 8.1% which is similar to the study conducted by Bhat et al 24 and Agrawal et al 14 . In their study occurance of endometrial hyperplasia was 9% and 9.6%% respectively.…”

Section: Discussionsupporting

confidence: 89%

Correlation of Abnormal Uterine Bleeding (AUB) with Thyroid Profile and Endometrial Biopsy

Koirala

Pande

Shrestha³

2021

Nep. Med. Coll. J.

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Abnormal uterine bleeding (AUB) is defined as any change in the frequency of menstruation, duration of flow or amount of loss. Menstrual disturbances and different endometrial pattern may accompany and precede thyroid dysfunction. The objective of the study was to correlate thyroid profile with endometrial biopsy in cases of AUB. This study was conducted on 74 patients who presented with AUB, had undergone TFT and endometrial biopsy/hysterectomy. Among 74 patients, thyroid disorders were identified in 26 patients. Maximum number of patients with AUB belonged to the category of hypothyroidism (27%) and 8.1% of cases had hyperthyroidism. In the present study 29 (39.1%) had proliferative endometrium, followed by secretory pattern in 21 (28.4%) patients. Hormone induced changes was seen in 3 (4.1%) patients. Disordered proliferative endometrium and endometrial hyperplasia was observed in 6 patients (8.1%) each. Malignant lesion was not common and it comprised of only 1.4% cases. AUB is frequently seen in patients with thyroid dysfunction. Thyroid function test is a cost effective, easily available test and can detect a possibly curable cause of AUB and avoid unnecessary intervention like hormonal treatment and hysterectomy. AUB due to endometrial cause is an age related pathology. Histopathological examination of endometrial biopsy is a major diagnostic tool in evaluation of AUB. It helps the physician to plan therapy for successful management of AUB.

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“…In present study group women with parity 1 were (20.7%) and parity 2 were (55.38%) which is corresponding to study done by Byna et al where 16.9% were para 1 and 55.4% were para 2. 8 Similar results were found in the study done Betha et al where maximum patients were parity 2 (44%) followed by parity 3 (36%). 5 Adenomyosis was more common in multiparous women, with the diffuse subtype predominating.…”

Section: Discussionsupporting

confidence: 87%

Distribution of causes of abnormal uterine bleeding according to PALM COEIN classification in tertiary health centre and its histopathological correlation

Sharma

Maurya

Kumari

2021

Int J Reprod Contracept Obstet Gynecol

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Background: AUB is a common problem among women of all ages, accounting for 20-30% of outpatient visits in the reproductive age group and 69 percent in the peri or postmenopausal age group. It has a major effect on women's personal, social, physical, and psychological well-being.Methods: This prospective observational research was performed at J K Lone Mother and Child Hospital and Government Medical College, Kota, Rajasthan, from date January 2018 to July 2019, in the department of obstetrics and gynecology. The researchers looked at all women in the 40-year-old age group who had AUB and were not responding to nonsurgical care. Several causes of PALM and COEIN were investigated, and a histo-pathological association was calculated.Results: Total 60 women with AUB not responding to medical management were taken. Majority (53.3%) women were between 40-50 years of age. Majority (63%) were para 2.Most common associated structural cause was leiomyoma (31%) followed by adenomyosis (25%) followed by ovulatory dysfunction (18%) followed by malignancy and polyp (10%).Most common histopathological finding was secretory phase (31.7%) followed by proliferative phase (28.3%) and then by hyperplasia (21.7%).ROC curve analysis showed that AUB-PALMCOEIN can predict diagnosis up to 95.8%. P value analysis for polyp, fibroid, ovulatory, endometrial was not significant showing that AUB-PALMCOEIN can predict diagnosis as much as histopathological examination. P value analysis for adenomyosis and malignancy was significant showing histopathology to be more accurate in giving diagnosis.Conclusions: The PALM-COEIN classification aids in determining the cause of AUB and, as a result, efficiently adopting and planning for patient care. The structural cause of AUB played a larger role in the development of AUB. The major causes of AUB were divided into structural and non-structural causes in this research. The COEIN part of the classification needs to be improved further through in-depth analysis.

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Histopathological correlation of abnormal uterine bleeding in perimenopausal women

Cited by 7 publications

References 1 publication

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study

Correlation of Abnormal Uterine Bleeding (AUB) with Thyroid Profile and Endometrial Biopsy

Distribution of causes of abnormal uterine bleeding according to PALM COEIN classification in tertiary health centre and its histopathological correlation

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