Postmenopausal bleeding: clinicopathologic study in a teaching hospital of Andhra Pradesh
Keywords:
Postmenopausal bleeding, Endometrial thickness, Pelvic ultrasoundAbstract
Background: Postmenopausal bleeding (PMB) requires complete assessment in order to ensure the absence of malignancy and to identify and treat high risk patients such as those with endometrial hyperplasia. The aim of the present study was to investigate the clinical significance and endometrial pathology in patients with postmenopausal bleeding.
Methods: A retrospective study on postmenopausal women visiting Bhaskar Medical College & general hospital, Yenkapally, Andhra Pradesh between 2009-2011 was undertaken. About 30 patients (aged between 50-60 years) with postmenopausal bleeding were selected and these patients were evaluated by curettage, pelvic ultrasound and endometrial histology.
Results: The commonest finding of pelvic USG was increased endometrial thickness (>4mm) (80%). The histopathological analysis showed proliferate endometrium (36.3%), atrophic endometrium (16.6%), cystoglandular hyperplasia (10%) and endometrium hyperplasia (6.6%). Incidence of cervical and endometrial carcinomas was 10% and 6.6%, respectively.
Conclusion: the postmenopausal bleeding is an important symptom and requires careful and timely assessment to eliminate the possibility of malignancy as soon as possible.
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References
W.H.O. Research on the menopause in the 1990s. Report of a WHO Scientific Group. World Health Organization technical report series 1996;866:1-107.
Hawwa ZM, Nahhas WA, Copenhaver EH. Postmenopausal bleeding. Lahey Clinic Foundation Bulletin 1970; 19:61-70.
Astrup K, Olivarius Nde F. Frequency of spontaneously occur ring postmenopausal bleeding in the general population. Acta Obstetricia et Gynecologica Scandinavica 2004; 83(2):203-7.
Ronghe R, Gaudoin M. Women with recurrent postmenopausal bleeding should be re-investigated but are not more likely to have endometrial cancer. Menopause International 2010;16(1):9-11.
Escoffery CT, Blake GO, Sargeant LA. Histopathological findings in women with postmenopausal bleeding in Jamaica. West Indian Medical Journal 2002;51(4):232-5.
Gredmark T, Kvint S, Havel G, Mattsson LA. Histopathological findings in women with postmenopausal bleeding. British Journal of Obstetrics and Gynaecology 1995;102(2):133-6.
Lee WH, Tan KH, Lee YW. The aetiology of postmenopausal bleeding–a study of 163 consecutive cases in Singapore. Singapore Medical Journal. 1995;36(2):164-8.
Kaur M, Singh R, Sharma M. Endovaginal sonographic evaluation of postmenopausal uterine bleeding. Journal of Clinical & Diagnostic Research 2010;(4):2175-82.
Ferrazi E, Torri V, Trio D, Zannoni E, Filiberto S, Doedoni D. sonographic endometrial thickness: a useful test to predict atrophy in patients with postmenopausal bleeding. Italian multicenter study. Ultrasound in Obstetrics and Gynecology 1996;7;315-21.
Sahdev A. Imaging the endometrium in postmenopausal bleeding. British Medical journal 2007;334(7594):635-6.
Smith-Bindman R, Weiss E, Feldstein V. How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound in Obstetrics and Gynecology 2004;24(5):558-65.
Gupta JK, Chien PF, Voit D, et al. Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a metaanalysis. Acta Obstetricia et Gynecologica Scandinavica 2002 Sep;81(9):799-816.
Breijer MC, Timmermans A, van Doorn HC, Mol BW, Opmeer BC. Diagnostic strategies for postmenopausal bleeding. Obstetrics and Gynecology International 2010;2010:850812. doi: 10.1155/2010/850812.
Pl So, Wk Sin, Hc Lee, Kc Au Yeung. Evaluation of Recurrent Postmenopausal Bleeding. Hong Kong Journal of Gynaecology, Obstetrics and Midwifery 2012;12(1):69-79.
Caspi E, Perpinial S, Reif A. Incidence of malignancy in Jewish 13. Women with postmenopausal bleeding. Israel Journal of Medical Sciences 1977;13(3):299-304.
Bani-Irshaid I, Al-Sumadi A. Histological findings in women with postmenopausal bleeding: Jordanian figures. Eastern Mediterranean Health Journal 2011;17(7):582-86.
Fortier KJ. Postmenopausal bleeding and the endometrium. Clinical Obstetrics and Gynecology 1986;29:44-5.
Gredmark T, Havel G, Mattsson L-A. Histopathological findings 15. in women with postmenopausal bleeding. British Journal of Obstetrics and Gynaecology 1995;102(2):133-6.
Bafna UD, Shashikala P. Correlation of endometrial ultrasonography and endometrial histopathology in patients with postmenopausal bleeding. Journal of the Indian Medical Association 2006;104(11):627-9.
Udigwe GO, Ogabido CA. A clinico-pathological study of cervical carcinoma in South Eastern Nigeria; a five-year retrospective study. Nigerian Journal of Clinical Practice 2008;11(3):202-5.
