Abnormal uterine bleeding in perimenopausal women: Clinical histopathological and sonography correlation

Shahana Ishaq Chandniwala,Mahima Jain

doi:10.18231/j.ijogr.2020.085

Abstract

Patient who underwent hysterectomy for Abnormal Uterine Bleeding their clinical findings were related to sonography and histopathology reports.This is retrospective observational study conducted in obstetric and gynaecology department. Patient who have undergone hysterectomy for AUB, their data retrived from case file and their ultrasonography reports and histopathological examination reports were compared.153 women who have under gone hysterectomy had complaint of menorrhagia and they belong to perimenopausal age group, most of them were between 40-45 years of age. Ultrasonography is suggestive of fibroid in most of the patients and it is most sensitive for diagnosis of uterine fibroid.Fibroid is a most common cause of AUB. Clinical, sonography and histopathological findings correlated well with the diagnosis.

Highlights

Abnormality in frequency, regularity, duration or volume of bleeding in women of reproductive age is called Abnormal Uterine Bleeding (AUB)
AUB leads to loss of productivity[1] and may result in surgical intervention including hysterectomy.[2]
USG diagnosed 31 cases as having bulky uterus, which were clinically diagnosed as AUB, in which histopathology report were suggestive of normal myometrium in 18 cases, adenomyosis in 7, and leiomyoma in 3 cases. 72 cases had hyperplastic endometrium in histopathology report, only 11 were detected in ultrasonography

Summary

Introduction

Abnormality in frequency, regularity, duration or volume of bleeding in women of reproductive age is called Abnormal Uterine Bleeding (AUB). Quality of life is affected as it is associated with pain and discomfort. AUB leads to loss of productivity[1] and may result in surgical intervention including hysterectomy.[2] AUB affects 9 to 14% women between menarche and menopause. 4 AUB patterns include menorrhagia, metrorrhagia, polymenorrhea, dysfunctional uterine bleeding and heavy menstrual bleeding. To standardize nomenclature of AUB a system known by acronym PALM-COEIN was introduced in 2011 by FIGO. 5. Normal and abnormal parameters of menstruation parameters are characterized under FIGO nomenclature. Structural causes (PALM) Polyps Adenomyosis Leiomyomas Submucosa Others Malignancy and hyperplasia. Coagulopathy Ovulatory dysfunction Endometrial (Primary disorder of mechanisms regulating endometrial hemostasis) Iatrogenic Not yet specified

Materials and Methods

Exclusion criteria

Discussion

USG Findings

Conclusion

Source of Funding