Online ISSN: 2515-8260

Keywords : AUB


Comparative study of pipelle device versus conventional dilatation and curettage for endometrial sampling in diagnosis of endometrial pathology causing abnormal uterine bleeding or infertility in women > 25 years of age

Dr. Samita Bhat, Dr. Rooma Sinha, Madhumati Sanjay, Bana Rupa, Dr. Fozia Jelani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1588-1596

Background: Abnormal Uterine bleeding (AUB) is a cause of significant healthcare burden for the women, common methods for endometrial assessment are USG, hysteroscopy, D&C, however multiple newer outpatient method are becoming popular due to their ease of application and cost effectiveness. Present study was aimed to compare the diagnostic accuracy and histopathological success of Pipelle verses conventional curettage in diagnosing endometrial pathology in AUB cases.
Material and Methods: Present study was single-center, Prospective and comparative single blind study, conducted women aged 25 years, with complaints of abnormal uterine bleeding with or without infertility. Initially, endometrial sample was collected by pipelle sampler in the outpatient department followed by endometrial biopsy by curettage under general anesthesia.
Results: Out of 106 patient’s majority were from 40-60 years age group, had 2 or more parity. Majority had abnormal uterine bleeding alone (77.36%), infertility alone (10.37%) & infertility with abnormal uterine bleeding (12.26%). Common USG findings were endometrial polyp (19.81%), fibroid uterus (10.38%), adenomyosis (3.77%), cystic endometrium (3.77%) and Thickened Endometrium (1.89%). In women with AUB & infertility the sensitivity of pipelle in picking up the endometrial pathology was 100% as compared to D&C and specificity was 99.02%. The negative predictive value was 100% and Positive predictive value was 80%. In the premenopausal women the sensitivity, specificity, NPV & PPV are all 100% for Pipelle sample as compared to curettage. In the postmenopausal women, specificity & PPV was 100%, however sensitivity was 66% and NPV was 95.2%.
Conclusion: In women with AUB & infertility the sensitivity of pipelle in picking up the endometrial pathology was 100% as compared to D&C and specificity was 99.02%. The negative predictive value was 100% and Positive predictive value was 80%.

Study of endomed sampler for endometrial biopsy, by comparing the histopathology reports as gold standard

Dr. Shibin K, Dr. Shivakumar, Dr. Sajitha AK, Dr. Nishi K, Dr. Chellamma VK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2109-2114

Background: Abnormal uterine bleeding (AUB) is a major clinical problem in women of peri and post-menopausal age group. It accounts for 30%of outpatient population coming to a gynaecologist. Evaluation of AUB is important for ruling out endometrial carcinoma and its precursors. Endomed biopsy is an ideal method for obtaining endometrial sample with ease, low cost and without anaesthesia. To determine sensitivity, specificity, positive predictive value and negative predictive value of Endomed sampler, by comparing the histopathology reports of endometrial samplings with that of hysterectomy specimen, taken as gold standard. Methods: This study is carried out in 76 patients with abnormal uterine bleeding posted for hysterectomy. Endometrial sampling was done with Endomed in all patients. The histopathology report of endomed sample is compared with that of hysterectomy sample. Results: The mean age of study population in our study was 45.75 ± 7.19 years. The most common complaint was menorrhagia (39.5%), followed by polymenorrhagia (17.1%), dysmenorrhea and lower abdominal pain (14.5% each). Endomed sample was found to be adequate for 94.7% of the study population. Among the adequate samples, proliferative endometrium contributed to a 28.9%, followed by secretory endometrium (22.4%) and the least was hyperplasia with atypia (3.9%). Among the study population, 8 (10.5%) of them were found to have carcinoma endometrium with histopathology (HPR) report of hysterectomy specimen whereas 6 (7.9%) using Endomed sampling. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was found to be 100%, 88.2%, 96.97%, 100% and 97.22% respectively for Carcinoma Endometrium. Conclusion: Endometrial sampling by endomed method is safe, easy to perform, highly sensitive and specific for diagnosis of endometrial carcinoma and its precursors. Endomed sampling can be used as an alternative to D&C for sampling of endometrium.

PATTERN OF ABNORMAL UTERINE BLEEDING IN HYPOTHYROID FEMALES OF REPRODUCTIVE AGE GROUP – A PROSPECTIVE STUDY

Dr. Sabha Malik; Dr. Saba Musharaf; Dr. Natasha Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 2204-2208

Introduction: Thyroid dysfunction may have profound effect on the female reproductive system. Hypothyroidism results in change in cycle length and amount of bleeding leading to oligomenorrhea, amenorrhea, polymenorrhea, and menorrhagia Objective: This study was conducted to see menstrual patterns in hypothyroid females of reproductive age group in Kashmir, Jammu & Kashmir. Study Design: Prospective cohort study Material and Methods: 50 patients who presented to OPD with complaints of abnormal uterine bleeding in Dept of Obstetrics & Gynaecology, SKIMS, Kashmir were recruited. Statistical Analyses: Data presented as percentages for qualitative variables. For continuous variable, student ‘t-test’ was applied and to see for association among the variables , chi-square test was used. P value less than 0.05 was considered as statistically significant. Results: In our study among hypothyroid reproductive women, most common pattern of AUB was menorrhagia that was around 58% (29/50) followed by polymenorrhea 22 % (11/50). Hypomenorhea, oligomenorrhea and amenorrhea were present in 8%, 6 % and 6 % respectively. Conclusion: In hypothyroid females presenting with AUB, menorrhagia is the most common abnormal pattern of bleeding followed by polymenorrhea. Hypomennorhea, oligomennorhea and amenorrhea were less common.