Role of Ultrasonography and Endometrial Sampling in Perimenopausal Abnormal Uterine Bleeding
Background: Abnormal uterine bleeding (AUB) is a frequently encountered gynecologic complaint in perimenopausal woman. AUB is defined as any deviation from the normal menstrual pattern. These include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. However endometrial hyperplasia and carcinoma are commoner in perimenopausal and postmenopausal women warranting investigations like ultrasonography and endometrial biopsy.
Aims and Objective: To correlate histopathological findings in patients with AUB with transvaginal scan report in perimenopausal women.
Method: In present study, total 41 women of age 40 years or above, not pregnant, presenting with abnormal bleeding per vaginum were evaluated. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. Endometrial biopsy was done using a curette and tissue obtained was sent for histopathological examination. Findings of these diagnostic modalities were then correlated.
Results: Majority of cases (92.6%) were below 50 years, and multiparous. Obesity was the commonest (41.4 %) co-morbidity followed by hypertension (24.3%) and hypothyroidism (19.51%). USG was normal in most (41.4%) of the cases while structural abnormalities (polyp or leiomyoma) was the most common USG findings (34.13%) followed by hyperplasia (19.49%). Endometrial thickness (ET) was >8 in majority (68.52%) of cases. Proliferative endometrium was the most common histopathological finding (36.58%), only 1 case of malignancy was found.
Conclusion: Ultrasonography is useful for triaging abnormal uterine bleeding, but keeping risk factors in the mind, endometrial histopathology still has important role in the management of perimenopausal AUB.
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