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Abstract
A CLINICAL STUDY OF PERIMENOPAUSAL UTERINE BLEEDING
Dr. Megha Nandwani*, Dr. A. S. Singh, Dr. Ananya Das and Dr. Jaya Mishra
ABSTRACT
Aims: To determine the role of transvaginal ultrasonography in perimenopausal women with abnormal uterine bleeding and its correlation with histopathology. Materials and Methods: All cases of abnormal uterine bleeding in perimenopausal age group attending the Gynaecology Out Patient Department (GOPD) for check up during the period of the study fulfilling the inclusion criteria were enrolled in the study. All cases underwent TVS and endometrial thickness was noted for all patients followed by dilatation and curettage. Endometrial tissue obtained was sent for histopathology examination. Results: 81.8% cases of AUB belonged to the age 40 to 49 years. The most common endometrial pattern was secretory phase (43.6%) and most common endometrial pathology was simple hyperplasia without atypia (10.9%). Endometrial hyperplasia seen in 14.5% cases and endometrial carcinoma seen in only one case (0.9%).The values of endometrial thickness at which endometrial hyperplasia was commonly seen was 8 to 10mm.But the p value for patients with 8mm endometrial thickness as cut off for hyperplasia was 0.075 that was not statistically significant. Conclusion: In our study, the endometrial thickness at which endometrial hyperplasia was seen was >8mm and most common endometrial pathology was simple hyperplasia without atypia. Thus, all perimenopausal women with an endometrial thickness of more than 8mm should be considered for dilatation and curettage and further evaluation. Clinical Significance: AUB is a common diagnosis in perimenopausal women attending gynaecologic OPD. This study attempts to find the cause of AUB in a non-invasive way and to correlate clinical symptoms with diagnosis; so that invasive diagnostic and unnecessary surgeries can be avoided.
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