ENDOMETRIAL PATHOLOGY BY ENDOMETRIAL CURETTAGE IN MENORRHAGIA IN PREMENOPAUSAL AGE GROUP
Abstract
Background: Menorrhagia is objectively defined as blood loss greater than 80 ml or menstrual periodlasting longer than 7 days. Dysfunctional uterine bleeding is responsible for 80% cases of Menorrhagia.Objective of this study was to find out the endometrial pathology and usefulness of hysterocopicdirected endomentrial sampling in patient having menorrhagia in premenopausal age group. Methods:This prospective descriptive study was conducted at Unit 1 of the Department of Obstetrics andGynaecology, Fauji Foundation Hospital Rawalpindi, Pakistan from January to December 2007.During the study period, 100 patients with menorrhagia in age group 35–50 years were selected afterfulfilling the inclusion criteria. These patients were selected from Gynaecology out patient department.After detailed history, examination and ultra sonography, they were admitted and hysteroscopicdirected endometrial sampling was done endometrial samples were sent for histopathology to find outthe endometrial pathology. Results: The selected patients of my study with menorrhagia were scatteredover all premenopusal age groups >35 years. It was observed that 67 patient were above the age of 40years. The analysis of histopathology reports of endometrial curettage revealed proliferativeendomentrium in 33%, cystic hyperplasia’s in 25% and carcinoma endometrium in one case.Cystichyperplasia and proliferative endometrium were found in menorrhagic women over 40 years ofage. Adenoicarcinoma was found in a single premenopausal women of 48 years. Conclusion: Allpatients having menorrhagia above 40 years should be screened for any endometrial pathology.Accurate analysis of endometrial sampling is the key to effective therapy and optimal out come.Keyword: Hysterocopic guided endometrial curettage, Menorrhagia, Premenopause DUBReferences
Cameron IT. Menstural disorder. In: Edmond DK (edior).
Dewhurst’s text book of obstetrics and gynaecology for
postgraduate. 6th ed. London: Blackwell Science Press Limited;
p. 410–9.
Parveen F, Hashim HA. Dysfunctional uterine bleeding: A
histopathology study. J Coll physicians Surg Pak 1999;9:318–20.
Thomas SL, Ellertson C, Nauisance or Natural and health: should
monthly menstruation be option for women? Lancet
;355:922–4.
Dij khuizen FP, Mol BW, Brolmann HA, Heintz AP. The
accuracy of endometrial sampling in the diagnosis of patients
with endometrial carcinoma and hyperplasia. Cancer
;89:1765–72.
Bun Kheila AK, Powell MC. Menorrhagia and Dysfunctional
uterine bleeding. Current obstetrics and Gynaecology
;12:328–33.
Mac Mahon B. Overview of studieson endometrial cancer and
other typesof cancer in human: perspectives of an epidemiologist.
Semin Oncol 1997;24(Suppl 1):S1-122-S1-39.
Golddrath M.Office hysteroscopy and sanction curettage in the
evaluation of abnormal uterine bleeding. In: Cameron IT, Fraser IS,
Smith SIC (eds). Clinical disorders of the endometrium and
menstrual cycle. Oxford: Oxford University Press; 1998.p. 148–54.
Mary E, Rimsza MD. Dysfunctional uterine bleeding. Pediatr
Review 2002;23:227–33.
Cote I, Jacobs P, Cumming DC. Use of health services associated
with increased Menstrual loss in United States. Am J Obstet
Gynaecol. 2003;188:343–8.
Mazhar SB. Transcervical endometrial Resection for
menorrhagia. A review of 117 consecutive cases. J Coll
physician Surg Pak 1995;5(2):5–7.
Janet PA, Sharon KH, Robert MW. Abnormal uterine bleeding.
American Family Physician 2004;(3):20–8.
Kurovilla A, Sohan K, Ramsewak S. Out patient endometrial
sampling as the sole primary method for assessing abnormal
uterine bleeding in women over 35 years in Trinidad. Internet J
Gynaecol Obstet 2004;3:1528–40.
MacKenzie I, Bibby J. Critical assessment of dilation and
curettage of I, 029 women. Lancet 1978;2(8089):566–8.
J Ayub Med Coll Abbottabad 2010;22(3)
http://www.ayubmed.edu.pk/JAMC/PAST/22-3/Shazia.pdf
Shaheen S, Akhtar S, Utman N. Cause of menorrhagia and its
pathological diagnosis by Dilatation and curettage. J Postgrad
Med Inst 2005;19(1):62–6.
Fraser IS. Blood and total fluid content of menstrual discharge.
Obstet Gynaecol 1995;65:194–8.
Masamoto H, Nakama K, Kanazawa K. Hysteroscopic
appearance of the mid-secretory endometrium: relationship to
early phase pregnancy outcome after implantation. Hum Reprod
;15:2112–8.
Steiner RA, Fink D. Abnormal menstrual bleeding. Schweiz
Rundsch Med prax 2002 Nov 13;91:1967–74.
Alber JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am
Fam physician 2004;69:1915–26.
Goldstein SR. Menorrhagia and abnormal uterine bleeding before
the menopause. Best Pract Res Clin Obstet Gynaecol
;18(1):59–69.
Luqman M, Bukhari L. Abnormal excessive uterine hemorrhage:
a histopathology study. Pak J Pathol 1998;9:20–3.
Mughal N. Bleeding problems and treatment. Clin Obstet
Gynecol 1997;41(4):928–39.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
