Al Ameen Journal of Medical Sciences (Jul 2017)
Clinicopathological study of endometrium in cases of post menopausal bleeding per vaginum
Abstract
Introduction: A number of studies on clinical evaluation of post menopausal bleeding have been conducted worldwide but there are a few reports from India so this study was intended to present a hospital based survey to investigate the clinical significance of post menopausal bleeding in terms of etiology, risk factors, incidence of malignancy and histopathological evaluation. Objectives: a) To study the clinical features in a patient with post menopausal bleeding. b) To study the different pathological changes in endometrium in post menopausal bleeding patients. c) To study the effect of risk factors like diabetes, hypertension and obesity on histopathology. d) To evaluate the causes of post menopausal bleeding. Materials and methods: The study recruited 70 patients above the age of 45 years who presented with post menopausal bleeding. Histopathological examination was done. Results: Most common presenting complaint is bleeding per vaginum (43%), followed by recurrent bleeding (34%). Age ranged between 44-80 years. High incidence in age group of 50-54 years. Majority were multiparous (88%). In current study, 54.2% were diabetic, 51% obese and 45% hypertensive. 94% had benign pathology and only 6% showed malignant pathology. Majority cases had endometrial thickness 5-12 mm in transvaginal sonography. Majority had proliferative endometrium, followed by hyperplasia, atrophy, polyp and secretory endometrium. Conclusion: a) Every post menopausal bleeding case has to be thoroughly evaluated with history, examination (age, presence of diabetes, hypertension, BMI) and TVS. To improve diagnostic accuracy. b) Dilatation and curettage can provide sufficient diagnostic accuracy. c) Early diagnosis makes successful treatment of endometrial hyperplasia and endometrial cancer in post menopausal bleeding cases. d) Endometrial sampling is mandatory prior to therapeutic gesture.
