PDF(Pubmed)
Abstract：
BACKGROUND: Abnormal uterine bleeding (AUB) is a common troublesome symptom in the perimenopausal age group. The most common type of AUB in this age group is heavy menstrual bleeding. There is a risk of endometrial carcinoma and atypical endometrial hyperplasia in women with AUB in the age group of 40-50 years. Hence early evaluation is of paramount importance in managing women with perimenopausal heavy menstrual bleeding. The current study was undertaken to study the correlation between ultrasound findings and various benign and malignant endometrial histologies in perimenopausal women with heavy menstrual bleeding.
METHODS: Women aged 40-55 years presenting with heavy menstrual bleeding at the gynaecology outpatient department at Sree Balaji Medical College and Hospital, Chennai, India, were included in the study. Patients on anti-platelet and anti-coagulation therapy and patients already on hormonal treatment for heavy menstrual bleeding were excluded from the study. The demographic factors, symptom profiles, ultrasound findings, and histopathological reports were tabulated and analysed.
RESULTS: Of the 147 women included in the study, 75 (51%) were aged 45-50 years and 107 (73%) had two or more pregnancies. Fibroid was the common non-endometrial cause of heavy menstrual bleeding in 52 (35%) cases. The proliferative pattern was the most common non-pathological histology identified in 46 (31%) cases. Endometrial hyperplasia without atypia was the most common pathological histology observed in the study population. Endometrial thickness of more than 8 mm was strongly associated with premalignant or malignant endometrial lesions.
CONCLUSIONS: Our study has attempted to identify the correlation between ultrasound evaluation of perimenopausal women with heavy menstrual bleeding and endometrial pathology. Ultrasound, being cost-effective and widely available, is proven to be a tool for first-line investigation of perimenopausal women with heavy menstrual bleeding that guides further evaluation and management.
METHODS: Women aged 40-55 years presenting with heavy menstrual bleeding at the gynaecology outpatient department at Sree Balaji Medical College and Hospital, Chennai, India, were included in the study. Patients on anti-platelet and anti-coagulation therapy and patients already on hormonal treatment for heavy menstrual bleeding were excluded from the study. The demographic factors, symptom profiles, ultrasound findings, and histopathological reports were tabulated and analysed.
RESULTS: Of the 147 women included in the study, 75 (51%) were aged 45-50 years and 107 (73%) had two or more pregnancies. Fibroid was the common non-endometrial cause of heavy menstrual bleeding in 52 (35%) cases. The proliferative pattern was the most common non-pathological histology identified in 46 (31%) cases. Endometrial hyperplasia without atypia was the most common pathological histology observed in the study population. Endometrial thickness of more than 8 mm was strongly associated with premalignant or malignant endometrial lesions.
CONCLUSIONS: Our study has attempted to identify the correlation between ultrasound evaluation of perimenopausal women with heavy menstrual bleeding and endometrial pathology. Ultrasound, being cost-effective and widely available, is proven to be a tool for first-line investigation of perimenopausal women with heavy menstrual bleeding that guides further evaluation and management.
摘要：
背景：异常子宫出血（AUB）是围绝经期年龄组常见的麻烦症状。在这个年龄组中最常见的AUB类型是大量月经出血。在40-50岁年龄段的AUB女性中，存在子宫内膜癌和非典型子宫内膜增生的风险。因此，早期评估对于管理围绝经期大量月经出血的女性至关重要。本研究旨在研究月经大量出血的围绝经期妇女的超声检查结果与各种良性和恶性子宫内膜组织学之间的相关性。
方法：在SreeBalaji医学院和医院妇科门诊部出现大量月经出血的40-55岁女性，钦奈,印度,包括在研究中。接受抗血小板和抗凝治疗的患者以及已经接受激素治疗的月经大量出血的患者被排除在研究之外。人口因素，症状简介，超声检查结果，和组织病理学报告进行列表和分析。
结果：在纳入研究的147名女性中，75（51％）年龄在45-50岁之间，107（73％）有两次或更多次怀孕。在52例（35％）中，子宫肌瘤是月经大量出血的常见非子宫内膜原因。在46例（31％）病例中，增殖模式是最常见的非病理性组织学。无异型性的子宫内膜增生是在研究人群中观察到的最常见的病理组织学。子宫内膜厚度超过8mm与子宫内膜癌前病变或恶性病变密切相关。
结论：我们的研究试图确定围绝经期重度月经出血妇女的超声评估与子宫内膜病理之间的相关性。超声波,具有成本效益和广泛可用，已被证明是对围绝经期大量月经出血妇女进行一线调查的工具，可指导进一步的评估和管理。
方法：在SreeBalaji医学院和医院妇科门诊部出现大量月经出血的40-55岁女性，钦奈,印度,包括在研究中。接受抗血小板和抗凝治疗的患者以及已经接受激素治疗的月经大量出血的患者被排除在研究之外。人口因素，症状简介，超声检查结果，和组织病理学报告进行列表和分析。
结果：在纳入研究的147名女性中，75（51％）年龄在45-50岁之间，107（73％）有两次或更多次怀孕。在52例（35％）中，子宫肌瘤是月经大量出血的常见非子宫内膜原因。在46例（31％）病例中，增殖模式是最常见的非病理性组织学。无异型性的子宫内膜增生是在研究人群中观察到的最常见的病理组织学。子宫内膜厚度超过8mm与子宫内膜癌前病变或恶性病变密切相关。
结论：我们的研究试图确定围绝经期重度月经出血妇女的超声评估与子宫内膜病理之间的相关性。超声波,具有成本效益和广泛可用，已被证明是对围绝经期大量月经出血妇女进行一线调查的工具，可指导进一步的评估和管理。
