To see the other types of publications on this topic, follow the link: Chronic Abnormal Uterine Bleeding.
Journal articles on the topic 'Chronic Abnormal Uterine Bleeding'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Chronic Abnormal Uterine Bleeding.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Benetti-Pinto, Cristina, Ana Rosa-e-Silva, Daniela Yela, and José Soares Júnior. "Abnormal Uterine Bleeding." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 39, no. 07 (2017): 358–68. http://dx.doi.org/10.1055/s-0037-1603807.
Full textAbstract:
AbstractAbnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic. Didactically, the treatment options were based on the current International Federation of Gynecology and Obstetrics (FIGO) classification system (PALM-COEIN). The etiologies of PALM-COEIN are: uterine Polyp (P), Adenomyosis (A), Leiomyoma (L), precursor and Malignant lesions of the uterine body (M), Coagulopathies (C), Ovulatory dysfunction (O), Endometrial dysfunction (E), Iatrogenic (I), and Not yet classified (N). The articles were selected according to the recommendation grades of the PubMed, Cochrane and Embase databases, and those in which the main objective was the reduction of uterine menstrual bleeding were included. Only studies written in English were included. All editorial or complete papers that were not consistent with abnormal uterine bleeding, or studies in animal models, were excluded. The main objective of the treatment is the reduction of menstrual flow and morbidity and the improvement of quality of life. It is important to emphasize that the treatment in the acute phase aims to hemodynamically stabilize the patient and stop excessive bleeding, while the treatment in the chronic phase is based on correcting menstrual dysfunction according to its etiology and clinical manifestations. The treatment may be surgical or pharmacological, and the latter is based mainly on hormonal therapy, anti-inflammatory drugs and antifibrinolytics.
2
Z.I., Hladchuk, Rozhkovska N.M., Sytnikova V.O., and Syvyi S.M. "Morphofunctional features of isthmocele complicated by abnormal uterine bleeding." REPRODUCTIVE ENDOCRINOLOGY, no. 73 (October 18, 2024): 30–34. https://doi.org/10.18370/2309-4117.2024.73.30-34.
Full textAbstract:
<strong>Background</strong>. The frequency of cesarean section remains high, and in some countries it exceeds 40% of all deliveries. The prevalence of isthmoceles as a consequence of cesarean section according to different authors ranges from 19 to 84%. Symptomatic isthmoceles is most often accompanied by abnormal uterine bleeding in 30-55% of women.<strong>Objective of the study</strong>: to determine the functional, morphological and immunohistochemical features of isthmocele complicated by abnormal uterine bleeding.<strong>Materials and methods</strong>. A prospective study was conducted, 68 patients were under observation: 38 patients of reproductive age with isthmocele after cesarean section who sought medical care for abnormal uterine bleeding (group 1, the main) and 30 practically healthy women of the same age with a normal uterine scar (group 2, the control). Immunohistochemical examination was performed in paraffin sections. Primary and secondary antibodies were used to detect CD34, CD68 and CD138 markers.<strong>Results</strong>. Patients with isthmocele complicated by abnormal uterine bleeding have an increased body mass index, a higher frequency of dysmenorrhea, excessive menstruation, heavy menstrual bleeding, intermenstrual bleeding, anemia, compared with women with a complete uterine scar (p < 0.01). Isthmoceles in 84.2% of cases was associated with ultrasonographic and pathologic signs of adenomyosis, with insufficiently effective treatment of abnormal uterine bleeding noted in 78.9% of cases, and no effect of conservative treatment in 21.1% of cases. The high expression of CD34, CD68, CD138 markers in the areas of the isthmoceles complicated by abnormal uterine bleeding indicates the activity of adenomyosis and the presence of chronic endometritis, which determines the specificity of the clinical picture and requires improvement of treatment approaches.<strong>Conclusions</strong>. Accounting the functional, morphological and immunohistochemical features of isthmocoele complicated by abnormal uterine bleeding will improve the effectiveness of treatment of symptomatic isthmocoele.
3
Barros, Venina Viana de, Eliane Azeka Hase, Cristiano Caetano Salazar, Ana Maria Kondo Igai, Fernanda Andrade Orsi, and Paulo Francisco Ramos Margarido. "Abnormal uterine bleeding and chronic iron deficiency." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 44, no. 12 (2022): 1161–68. http://dx.doi.org/10.1055/s-0042-1760235.
Full text
4
Radzinsky, V. E., M. B. Khamoshina, M. R. Orazov, Yu S. Artemenko, and I. A. Mullina. "Abnormal uterine bleeding and obesity: current paradigm." Voprosy ginekologii, akušerstva i perinatologii 21, no. 6 (2023): 54–64. http://dx.doi.org/10.20953/1726-1678-2023-6-54-64.
Full textAbstract:
Abnormal uterine bleeding (AUB) remains one of the most common gynecological disorders that reduce the quality of life and reproductive potential in women. Obesity is recognized as an independent risk factor for the development of AUB associated with irregular endometrial proliferation (endometrial hyperplasia and endometrial cancer), ovulatory dysfunction and disease recurrence. The role of obesity in the pathogenesis of AUB due to endometrial dysfunction is an interesting and understudied aspect. Chronic adipose tissue inflammation is mechanistically linked to metabolic disease and organ tissue complications in overweight and obese women. Despite its minor nature, low-grade adipose tissue inflammation negatively impacts remote organ functions, thus being a cause of obesity complications. The results of recent studies suggest that obesity creates conditions for a proinflammatory environment in the endometrium during menstrual bleeding, which may inhibit endometrial regeneration and increase the volume of menstrual blood loss. Key words: abnormal uterine bleeding, obesity, chronic latent inflammation, endometrial dysfunction, endothelial dysfunction
5
Saleh, Hend S., Nadia M. Madkour, Ahmed Mahmoud Abdou, et al. "Role of Multidetector Computed Tomography (CT) Virtual Hysteroscopy in the Evaluation of Abnormal Uterine Bleeding in Reproductive Age." BioMed Research International 2019 (January 21, 2019): 1–6. http://dx.doi.org/10.1155/2019/8910374.
Full textAbstract:
Background. Abnormal uterine bleeding (AUB) may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy. It is a widespread complaint in the primary care units. The prevalence of abnormal bleeding is up to 30% among women of reproductive age. Objective. To assess the role of CT virtual hysteroscopy in the evaluation of the uterine cavity in cases with abnormal uterine bleeding in reproductive age. Methods. Cross sectional study was performed at Obstetrics and Gynecology Department and Radiology Department, Zagazig University hospitals, Egypt, on 124 women with abnormal uterine bleeding in reproductive age, and their uterine cavity was evaluated by both row multidetector computed tomography (MDCT) scanner and Office hysteroscopy. Results. Mean age of studied group was 28.54 ± 5.99 years, and virtual hysteroscopy showed sensitivity 91.1% and specificity 85.3% in detection of abnormalities within uterine cavity. It showed sensitivity 91.1% and specificity 85.3% in cases of endometrial polyps. It yielded 88.5 % sensitivity and 100 % specificity in cases with submucous fibroids, while it yielded only 57.9 % sensitivity and 82.9% specificity in cases of thick endometrium. Conclusion. Virtual CT hysteroscopy is a good negative test in cases of abnormal uterine bleeding but has some limitations that decrease its sensitivity.
6
Hladchuk, Z. I., N. M. Rozhkovska, V. O. Sytnikova, and S. M. Syvyi. "Morphofunctional features of isthmocele complicated by abnormal uterine bleeding." REPRODUCTIVE ENDOCRINOLOGY, no. 73 (October 18, 2024): 30–34. https://doi.org/10.18370/2309-4117.2024.73.30-34.
Full textAbstract:
Background. The frequency of cesarean section remains high, and in some countries it exceeds 40% of all deliveries. The prevalence of isthmoceles as a consequence of cesarean section according to different authors ranges from 19 to 84%. Symptomatic isthmoceles is most often accompanied by abnormal uterine bleeding in 30-55% of women. Objective of the study: to determine the functional, morphological and immunohistochemical features of isthmocele complicated by abnormal uterine bleeding. Materials and methods. A prospective study was conducted, 68 patients were under observation: 38 patients of reproductive age with isthmocele after cesarean section who sought medical care for abnormal uterine bleeding (group 1, the main) and 30 practically healthy women of the same age with a normal uterine scar (group 2, the control). Immunohistochemical examination was performed in paraffin sections. Primary and secondary antibodies were used to detect CD34, CD68 and CD138 markers. Results. Patients with isthmocele complicated by abnormal uterine bleeding have an increased body mass index, a higher frequency of dysmenorrhea, excessive menstruation, heavy menstrual bleeding, intermenstrual bleeding, anemia, compared with women with a complete uterine scar (p < 0.01). Isthmoceles in 84.2% of cases was associated with ultrasonographic and pathologic signs of adenomyosis, with insufficiently effective treatment of abnormal uterine bleeding noted in 78.9% of cases, and no effect of conservative treatment in 21.1% of cases. The high expression of CD34, CD68, CD138 markers in the areas of the isthmoceles complicated by abnormal uterine bleeding indicates the activity of adenomyosis and the presence of chronic endometritis, which determines the specificity of the clinical picture and requires improvement of treatment approaches.Conclusions. Accounting the functional, morphological and immunohistochemical features of isthmocoele complicated by abnormal uterine bleeding will improve the effectiveness of treatment of symptomatic isthmocoele.
7
Bohiltea, Roxana Elena, Nicolae Bacalbasa, Irina Balescu, et al. "Abnormal uterine bleeding: Terminology, FIGO classification and management." Romanian Medical Journal 68, S6 (2021): 49–59. http://dx.doi.org/10.37897/rmj.2021.s6.8.
Full textAbstract:
Throughout the history of medicine, a wide range of terms has attempted to define normal menstruation and abnormal uterine bleeding in relation to its various etiologies. Over time, terminological variations have hampered the documentation of symptoms, the establishment of consensus on the use of various diagnostic techniques and medical or surgical methods of treatment, and the results of multicenter or multinational clinical trials. Abnormal uterine bleeding (AUB) in women of reproductive age is a common gynecological symptom outside of pregnancy, which includes any symptomatic variation starting from the criteria defining normal menstruation, respectively variations in frequency, regularity, duration, or volume, including intermenstrual bleeding, formerly known as spotting. Abnormal intermenstrual bleeding is typically associated with benign lesions such as chronic cervicitis or cervical or endometrial polyps, although it can rarely be caused by cervical or endometrial cancers. Abnormal uterine bleeding in postmenopause requires endometrial biopsy.
8
Byrchak, I., S. Yasnikovska, and A. Goshovska. "Features of thrombocyte-vascular hemostasis in women with abnormal uterine bleeding and submucosal uterine fibroids." Bukovinian Medical Herald 25, no. 2(98) (2021): 9–12. http://dx.doi.org/10.24061/2413-0737.xxv.2.98.2021.2.
Full textAbstract:
Objective – to investigate the features of platelet-vascular hemostasis in women with abnormal uterine bleeding on the background of submucosal uterine fibroids.Material and methods. The study included 30 women with abnormal uterine bleeding with submucosal uterine fibroids. Features of thrombocyte-vascular hemostasis were studiedResults. There are new data in relation to the features of certain links of the adjusting system of the aggregate state of blood on a background development of post hemorrhage anaemia. It is clearly shown that changes in the system of adjusting of the aggregate state of blood in women with a severe degree of anaemisation are the display of subclinical inopexi.Conclusions. Changes in the fibrinolytic potential of blood in women with chronic posthemorrhagic anemia on the background of abnormal uterine bleeding and submucosal uterine fibroids are secondary, due to the activation of thrombin and fibrinogenesis by external mechanisms.
9
Paudel, Deliya, and Himanshu Regmi. "Endometrial pattern in women with abnormal uterine bleeding attending a tertiary care centre of Kathmandu." Journal of Pathology of Nepal 14, no. 1 (2024): 2147–49. http://dx.doi.org/10.3126/jpn.v14i1.60327.
Full textAbstract:
Background: Abnormal uterine bleeding is one of the most common problems among pre and postmenopausal women. Abnormal uterine bleeding is diagnosed when there is a substantial change in frequency, duration, or amountof bleeding during or between periodsin the absence of any organic pathology. The study was perform to assess the endometrial causes of abnormal uterine bleeding and their incidence in different age groups. Materials and methods: It was a cross sectional and descriptive study carried out at a Manmohan medical College & hospital, over a period of two year from 13th April, 2020 to 15th March, 2022. In the study all the endometrial tissue either obtained by endometrial curettage and biopsy or hysterectomy presenting with abnormal uterine bleeding for more than 3 months were included Results: A total of 88 cases were received during this period, out of which there were 78 endometrial tissue samples and 10 hysterectomy specimens. The patient’s age ranged from 20 years to 73years. The pattern of endometrial biopsy are Proliferative (37.5%) and secretory (20.45%) phase endometrium is the most common pattern seen, followed by disordered proliferative endometrium (13.63%), endometrial hyperplasia without atypia (9.09%), Change consistent with Exogenous Hormone (5.68%), Chronic Endometritis (5.68%), Endometrial Polyp(3.40%), Endometrial Hyperplasia with Atypia(2.27%) and Endometrial Carcinoma (2.27%). Conclusions: Patients with abnormal uterine bleeding show a varying spectrum of endometrial pattern. Cyclic endometrium is commonly seen in the reproductive age group whereas hyperplasia and carcinomas are seen in pre/postmenopausal age group. Endometrial biopsy with histopathological examination is a major diagnostic tool in the evaluation of abnormal uterine bleeding.
10
K.V., Fedosiuk. "The psycho-functional state of women with abnormal uterine bleeding and chronic stress." Reproductive Health of Woman, no. 7-8 (November 1, 2021): 63–65. https://doi.org/10.30841/2708-8731.7-8.2021.250836.
Full textAbstract:
<strong>The objective:</strong> a study the levels of anxiety and stress in women with abnormal uterine bleeding (AUB) and chronic psycho-emotional stress. <strong>Materials and methods.</strong> We examined 100 women of reproductive age with AUB and chronic stress (basic group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis according to the order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The level of stress was assessed on Reeder stress scale, anxiety – scale of the Spielberger State-Trait Anxiety Inventory. <strong>Results.</strong> It was found that the mean trait anxiety score in all groups of women corresponded to the middle level, however, in patients with AUB and chronic stress, this indicator (44.07±1.05 points) was significantly higher than in the other two groups (40.08±1.20 points – in the comparison group and 37.80±1.29 – control group). The level of state anxiety in patients with AUB and chronic stress was high (48.15±0.85 points) and significantly more (p<0.001) relative to the patients with AUB without chronic psycho-emotional stress (42.42±1.21 points) and healthy women (39.80±1.43 points). The largest number of women with a high level of state anxiety was found in the basic group (58.00%, p=0.03) relative to the control group (33.33%). The mean of the stress level in patients with AUB and chronic stress was 2.11±0.05 points and was significantly less (p<0.001) relative to healthy women (2.94±0.09 points) and patients with AUB without chronic stress (2.88±0.05 points). A high level of stress was found in more than one third of patients in the basic group (37.00%) versus absence of such persons in the control and comparison groups (p<0.001). <strong>Conclusions.</strong> In women of reproductive age with AUB and chronic stress, there is an increase in the level of state anxiety and stress.
11
Mitrelis, R. Yu, L. M. Mikhaleva, M. R. Orazov, et al. "Morphological and functional features of spiral arteries in chronic endometritis of varying severity." CLINICAL AND EXPERIMENTAL MORPHOLOGY 14, no. 2 (2025): 43–51. https://doi.org/10.31088/cem2025.14.2.43-51.
Full textAbstract:
Introduction. Long-term chronic inflammation in the endometrium leads to sclerotic changes, disorders in the extracellular matrix and intercellular interactions, and, ultimately, to impaired formation of spiral arteries and hypoperfusion. The study aimed to compare morphological and functional changes in spiral arteries of the endometrium in patients with chronic endometritis of varying severity. Materials and methods. The research included ninety-five 20–40-year-old female patients that were divided into two groups. The main group comprised 60 patients with a history of abnormal uterine bleeding, and the comparison group consisted of women who underwent routine medical examinations. All women underwent diagnostic hysteroscopy with an endometrial pipelle biopsy on days 7–11 with a 28-day menstrual cycle. In histological sections stained with hematoxylin and eosin, we diagnosed chronic endometritis with immunohistochemical reaction with CD138 antibodies and counted the number of plasma cells. In addition, the presence or absence of fibrosis in the endometrial stroma was detected using Mallory staining. We assessed the external diameter of spiral arteries, vessel lumen diameter, and vessel lumen area. Results. We detected significant changes in blood vessels depending on the severity of chronic endometritis. These changes indicate the impaired formation of spiral arteries in the patients with a history of abnormal uterine bleeding associated with chronic endometritis. Conclusion. Our results allowed us to interpret the impaired biotransformation of the vascular compartment in patients with chronic inflammation, which has fundamental importance in the regulation of reproductive and menstrual functions. The severity of chronic endometritis directly affects pathological changes in the formation of spiral arteries in patients with a history of abnormal uterine bleeding. The established significant changes in endometrial blood vessels describe the mechanisms of pathogenesis of endometrial hypoxia followed by stromal fibrosis, hypoplasia, and hypoplastic endometrium formation, which causes impaired endometrial functioning. Keywords: chronic endometritis, abnormal uterine bleeding, vessel formation, morphometry
12
Chechulina, O. V., T. E. Kurmanbaev, L. M. Tukhvatullina, E. A. Khairullina, and I. G. Mustafin. "Disorders of hemostasis as the main pathogenetic mechanism in the development of menopausal abnormal uterine bleeding." Kazan medical journal 100, no. 4 (2019): 589–94. http://dx.doi.org/10.17816/kmj2019-589.
Full textAbstract:
The article presents our own clinical observations of cases of abnormal uterine bleeding in postmenopausal women, where the main cause was the pathology of hemostasis: a patient after liver transplantation for cirrhosis with chronic viral hepatitis C, and a patient with primary idiopathic thrombocytopenic purpura which manifested at a later age. Among the most common causes of abnormal uterine bleeding in postmenopausal women are hyperplasia and endometrial cancer, leiomyoma, are adenomyosis are distinguished. Pathology of the hemostasis system as the main cause of abnormal uterine bleeding, prevails in the pubertal and reproductive period. In the literature available we did not find any publications concerning uterine bleeding in postmenopausal patients against the background of the pathology of the blood coagulation system. This article illustrates the significance of hemostasis disorders both secondary and primary in the origin of abnormal bleeding in postmenopausal period. Careful collection of anamnesis, an indication of the occurrence of petechial rash, gingival bleeding should alert the doctor. It should also be remembered that “suddenly arisen” immune cytopenias and late-onset thrombosis are often manifestations of the hematological paraneoplastic syndrome and require the exclusion of neoplasia, first of all, of the hematopoietic system. These clinical observations allow recommending a mandatory examination of the hemostatic system in patients with postmenopausal bleeding.
13
Chernukha, G. E., I. A. Ivanov, Z. N. Efendieva, M. R. Dumanovskaya, and A. V. Asaturova. "Etiological structure and diagnosis of abnormal uterine bleeding." Gynecology 20, no. 2 (2018): 14–17. http://dx.doi.org/10.26442/2079-5696_2018.2.14-18.
Full textAbstract:
Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.
14
Usman, Fatimah. "Tatalaksana Praktis Gangguan Haid di Praktek Sehari-hari." Conferences of Medical Sciences Dies Natalis Faculty of Medicine Universitas Sriwijaya 1, no. 1 (2019): 180–88. http://dx.doi.org/10.32539/confmednatalisunsri.v1i1.22.
Full textAbstract:
Menstrual disorders are the most common disorders in women of childbearing age and the most common complaint in gynecological outpatient practices in several hospitals. Besides disrupting activities, menstrual disorders can be a serious problem as a life threatening condition. Menstrual disorders can be divided based on the duration and the etiology. Based on the duration of occurrence, acute and chronic can be distinguished. Etiology can be distinguished based on abnormal uterine bleeding criteria (PALM-COEIN). The management of this kind of disorder depends on the type of cause of abnormal uterine bleeding. Surgical and non-surgical management can be used as an option in the treatment of menstrual disorders. Hormonal therapy options are the most popular treatment options at present with minimal side effects and relatively affordable prices. Management of abnormal uterine bleeding aims to improve the general condition, stop bleeding, and restore the function of reproductive hormones. Stopping bleeding can be done with medical, dilatation and curettage, as well as operative measures.
15
K.V., Fedosiuk. "Assessment of hormonal homeostasis in women with abnormal uterine bleeding and chronic stress." Reproductive Health of Woman, no. 9-10 (December 30, 2021): 39–41. https://doi.org/10.30841/2708-8731.9-10.2021.252587.
Full textAbstract:
<strong>The objective:</strong> to study the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones, testosterone, prolactin and cortisol in women with abnormal uterine bleeding (AUB) and of chronic psycho-emotional stress. <strong>Materials and methods.</strong> We examined 100 women of reproductive age with AUB and chronic stress (main group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis was made on the basis of order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentrations of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin and cortisol were determined in blood serum in all the women in the follicular phase of the menstrual cycle using the ELISA method. <strong>Results.</strong> In patients with AUB and chronic stress, a significant decrease of estradiol by 37.50% relative to healthy women, FSH – 44.42%, LH – 22.12%, progesterone – 38.23% and a significant increase in prolactin by 41.92% and cortisol – 82.96% were established. In the patients with AUB without chronic stress a significant decrease in estradiol level by 23.95%, FSH by 22.09% and progesterone by 21.91%, and a significant increase in cortisol by 21.55% were found. The concentration of testosterone in the main group and the comparison group, as well as changes in the levels of LH and prolactin in the patients of the comparison group, were insignificant relative to the control group. <strong>Conclusions.</strong> In women of reproductive age with abnormal uterine bleeding and chronic stress, there is a significant decrease in the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones in the blood serum, an increase of prolactin and cortisol, and the absence of significant changes in testosterone level in the follicular phase of the menstrual cycle.
16
Bohiltea, Roxana-Elena, Bianca-Margareta Mihai, Valentin Varlas, et al. "Levonorgestrel intrauterine device as a non-invasive approach of abnormal uterine bleeding caused by cesarean scar defect." Romanian Medical Journal 68, no. 4 (2021): 461–64. http://dx.doi.org/10.37897/rmj.2021.4.8.
Full textAbstract:
Cesarean scar defect, niche or isthmocele represents a poor healing in the anterior uterine wall after performing a cesarean section. The cesarean scar defect can be asymptomatic, or the patient could present abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia, cesarean scar pregnancy or abnormal placenta. Abnormal uterine bleeding caused by cesarean scar defect presents as a postmenstrual spotting and has become more and more common among women with a history of minimum one cesarean section delivery. The most studied risk factors are: multiple cesarean section deliveries, single layer suture, locked suture, retroflexed uterus and cesarean section delivery performed during active labor with a cervical dilatation of 5 cm. There have been described several surgical approaches: hysteroscopic, laparoscopic or vaginal. From our experience, we have treated successfully symptomatic patients with cesarean scar defect with the levonorgestrel-releasing intrauterine system. Although the therapeutic indications do not include this specific use, we have obtained significant improvement of abnormal uterine bleeding due to cesarean scar defect in our patients. Our results sustain the necessity of extensive interventional studies.
17
Shinde, Pratibha T., Dilip S. Sarate, Suwarna B. Patil, Bhupendra V. Patil, and Swarada V. Kangate. "Study of histopathological pattern of endometrium in abnormal uterine bleeding in a tertiary care center." International Journal of Research in Medical Sciences 11, no. 4 (2023): 1170–74. http://dx.doi.org/10.18203/2320-6012.ijrms20230856.
Full textAbstract:
Background: It is estimated that 9-30% of women of reproductive age suffer from abnormal uterine bleeding. As most cases are associated with anovulatory menstrual cycles, adolescent and perimenopausal women are particularly vulnerable to this particular condition. The aim of this study was to evaluate the histopathological pattern of endometrial biopsy from patients presenting with abnormal uterine bleeding. Methods: The retrospective study was conducted in the Department of Pathology in tertiary care centre from 1st January 2021 to 31 December 2022. All the patients presenting with abnormal uterine bleeding and who underwent endometrial biopsy were included in this study. Distribution of various histopathological patterns was observed in the different age groups. Results: A total of 260 cases were included in the study. The commonest pattern in these patients was proliferative endometrium (31 %) and products of conception (31%), hyperplasia without atypia (13.7%). Other patterns identified were secretory endometrium, chronic endometritis, endometrial polyp, complete mole, partial mole, and Ca endometrium. Conclusions: As observed from the study, there is an age specific association of endometrial bleeding, with highest incidence in 21-30 years of age group. Hence, dilatation and curettage are helpful for diagnosis, to assess therapeutic response and to know the pathological incidence of organic lesions in cases of abnormal uterine bleeding.
18
Zubair, Roma, Arifa Yousafzai, Misbah Sheraz, Saima Gul, Nadia Rani, and Izhar Muhammad. "FREQUENCY OF DIFFERENT ABNORMAL HISTOPATHOLOGIES IN PERIMENOPAUSAL FEMALES WITH ABNORMAL UTERINE BLEEDING." JOURNAL OF KHYBER COLLEGE OF DENTISTRY 14, no. 2 (2024): 16–20. http://dx.doi.org/10.33279/jkcd.v14i2.727.
Full textAbstract:
Objectives: To determine the frequency of diff erent histopathologies in perimenopausal femaleswith abnormal uterine bleeding.Materials and Methods: This descriptive cross sectional Study was carried out at the in the department of obstetrics and Gynecology Lady reading hospital from 21st September 2022 to 21st March 2023. Informed consent was taken. Detailed history of patients presenting with complaints of Abnormal uterine bleeding was taken and systemic examination done. Preoperative investigations were done. Those patients meeting the inclusion criteria underwent dilatation and curettage (DNC) under general anesthesia. Endometrial biopsy sample was collected and sent for histopathological evaluation by pathology department of lady Reading Hospital.Results: The most common clinical presentation was represented by irregular vaginal bleeding in 48.6% patients followed by heavy menstrual bleeding in 34% cases and intermenstrual bleeding in 16.9% cases.The predominant histopathological pattern was Secretory endometrium (29.5%) followed by disordered proliferative (19.7%), chronic endometritis (19.1%), endometrial polyp(14.8%), simple endometrial hyperplasia (7.7%), endometrial carcinoma (5.5%), atrophic endometrium (3.8%).Conclusion: The intended study concludes that the most common histopathological pattern of endometrium in patients with AUB is secretory endometrium regardless of age, parity and ethnicity. Careful screening can detect cancer of endometrium in its early stage favoring excellent prognosis.These conditions can be managed medically thereby avoiding surgery and its associated risks.
19
Savelyeva, G. M., S. A. Mikhalev, A. G. Konoplyannikov, L. M. Mikhaleva, I. I. Babichenko, and M. N. Boltovskaya. "Chronic endometritis is an indication for the pregravid preparation." Journal of Clinical Practice 9, no. 2 (2018): 36–41. http://dx.doi.org/10.17816/clinpract09236-41.
Full textAbstract:
The crucial role of chronic endometritis in the genesis of endometrial dysfunction has been currently established. The inflammatory process serves as a co-factor and leads to a decrease in the receptivity of the sex hormones of the endometrium due to impaired blood circulation of the tissue and fibrosis in the stroma of the endometrium.
 This article is devoted to the study of the morpho-functional state of the endometrium in women of the reproductive age with abnormal uterine bleeding, in whom endometritis was diagnosed pathomorphologically, which is important for clarifying indications for the pregravid preparation in the future. A comprehensive examination of patients with abnormal uterine bleeding includes: bacterial culture (PCR) of the cervical canal and uterine cavity, hormonal profile, ultrasound examination of the pelvic organs and a complex histological examination of the uterine biopsy at the 7–10th and 19–21st days of the menstrual cycle, followed by immunohistochemical examination with the use of antibodies to the receptors of estrogens and progesterone, glycodelin, CD138, CD4, CD8, CD20.
20
Dikke, G. В. "Therapeutic tactics in abnormal uterine bleeding without anatomical substrate." Medical Council, no. 21 (January 20, 2019): 168–72. http://dx.doi.org/10.21518/2079-701x-2018-21-168-172.
Full textAbstract:
The purpose of the review:presentation of modern data on the pathogenesis of abnormal uterine bleeding (AMC) without anatomical substrate (ovulatory, endometrial, coagulopathic) and the effectiveness of their treatment with medication.Basic provisions.Information on the pathogenesis of AMC not associated with structural abnormalities of the uterus is presented. It was shown that non-hormonal drugs have similar efficacy. Among the hormonal agents, levonorgestrel-containing intrauterine system (IUD-LNG) and estrogen-progestogen preparations (combined oral contraceptives, COCs) favorably differ. COCs recover an acute episode of AMC in 66.8% of cases (according to some data – in 88%), which is higher in comparison with non-hormonal drugs; in chronic cases – reduce blood loss by 88% (after 6 months of therapy), and are not inferior in effectiveness to intrauterine devices with levonorgestrel (83% after 3 months of therapy).The conclusion.Thus, non-hormonal drugs have similar efficacy in arresting AMC without an anatomical substrate, but are inferior to COCs. In case of chronic AMC, the first-line drugs are IUD-LNG and COC containing E2B / NNG, which contribute to the normalization of the menstrual cycle and the volume of menstrual blood loss with proven efficacy.
21
Naveed, Sana, Amna Jahan, and Muhammad Naeem Raza. "Histopathological Pattern of Endometrial Abnormalities in Postmenopausal Women With Abnormal Uterine Bleeding." Biological and Clinical Sciences Research Journal 6, no. 4 (2025): 133–37. https://doi.org/10.54112/bcsrj.v6i4.1685.
Full textAbstract:
Abnormal uterine bleeding (AUB) in postmenopausal women often warrants prompt evaluation due to the risk of underlying malignancy or premalignant conditions. Histopathological examination of endometrial tissue remains a definitive diagnostic approach for identifying the etiology of AUB in this population. Objective: To assess the histopathological patterns of endometrial abnormalities in postmenopausal women presenting with abnormal uterine bleeding (AUB). Methodology: One hundred and forty five postmenopausal women aged ≥50 years with confirmed AUB were selected for this study. Non-endometrial causes of bleeding which were myometrial lesions, intrauterine devices, pregnancy-related complications, or hormone therapy were not included. Endometrial biopsies were obtained which were fixed in 10% formalin and processed for histopathological examination using hematoxylin-eosin staining. Histological findings were categorized as benign polyps, hyperplasia (with/without atypia), carcinoma, atrophic, proliferative, or secretory endometrium, and chronic endometritis. Results: Mean age was 55.19 ± 1.72 years. Atrophic endometrium was found in 32.4% patients, hyperplasia without atypia in 25.5%, secretory endometrium in 11.0%, and hyperplasia with atypia in 9.7% patients. Endometrial carcinoma was observed in 3.4% patients. Benign polyps and chronic endometritis were observed in 6.2% and 6.9% patients respectively. Conclusion: Atrophic endometrium was the leading pattern in postmenopausal women with abnormal uterine bleeding which was followed by hyperplasia without atypia and secretory endometrium.
22
Prakash, Tayade, Jain Sudhakar Neerja, Deshmukh Pravina, and Becon Ranjana. "Assessing the Efficacy and Role of MRI as an Imaging Modality in non-pregnant Females with Abnormal Uterine Bleeding." International Journal of Pharmaceutical and Clinical Research 13, no. 5 (2021): 355–62. https://doi.org/10.5281/zenodo.14224769.
Full textAbstract:
<strong>Background: </strong>The differential diagnosis and etiology of abnormal uterine bleeding are complex and varied. Histopathologic examinations are considered controversial to TAV and TAS making a non-invasive and advanced technology, MRI, a reliable tool and imaging modality for accurate diagnosis of abnormal uterine bleeding. <strong>Objectives<em>: </em></strong>The present study was conducted to assess the role and efficacy of MRI in abnormal uterine bleeding (AUB) patients. <strong>Methods<em>:</em></strong> In the present prospective clinical study, 102 subjects within the age of 21-85 years with abnormal uterine bleeding and who had prior surgery were assessed after recording detailed history and systemic examination. Following this, all subjects underwent MRI. The treatment was planned based on MRI diagnosis, medical conditions, desire to have further pregnancy, parity, and age. <strong>Result<em>: </em></strong>Majority of subjects were within the age range of 31-50 years, parity was 2. The duration complaint in study subjects were acute <6 months in 22.54% (n=23) subjects and was chronic >6 months in 77.45% (n=79) subjects. Bleeding pattern was PMB, IMB, HPMB, and HMB in 11.76% (n=12), 20.58% (n=21), 32.35% (n=33), and 35.29% (n=36) study subjects. Pressure symptoms, dysmenorrhea, dyspareunia, Discharge per Vaginum, Heaviness in lower Abdomen, and Pain in lower Abdomen in 9.80% (n=10), 15.68% (n=16), 10.78% (n=11), 14.70% (n=15), 12.74% (n=13), and 19.60% (n=20) study subjects respectively. No compliant was reported by 4.90% (n=5) study subjects. <strong>Conclusion<em>: </em></strong>The present study concludes that in subjects where clinical diagnosis is not confirmatory, sonography is decisive, even in subjects with no symptoms and normal findings. MRI is an accurate and promising imaging modality.
23
Medvedev, M. V. "Abnormal uterine bleeding: the role of office hysteroscopy." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 207–8. http://dx.doi.org/10.32902/2663-0338-2020-3.2-207-208.
Full textAbstract:
Background. Abnormal uterine bleeding (AUB) is any menstrual cycle disorder that does not meet normal parameters of regularity, frequency, duration, and intensity. AUB are divided into acute and chronic. According to modern paradygm, when describing menstrual disorders, terms “AUB”, “heavy menstrual bleeding”, “intermenstrual bleeding”, “postmenopausal bleeding” should be used.
 Objective. To highlight the role of office hysteroscopy in the treatment of AUB.
 Materials and methods. Analysis of literature sources on this topic.
 Results and discussion. According to the etiology, AUB are classified with the help of PALM-COEIN system: P – polyp, A – adenomyosis, L – leiomyoma, M – malignancy and hyperplasia (causes of structural disorders), C – coagulopathy, O – ovulatory dysfunction, E – endometrial dysfunction, I – iatrogenic causes, N – causes not established (causes not related to structural disorders). At different ages, the main causes of AUB are different (in childhood – injuries, infections, ovarian tumors, in childbearing age – anovulation, pregnancy, endocrine disorders, in old age – endometrial cancer). When examining patients with AUB, one should carefully collect a history, carry out physical and gynecological examination, determine the condition of the thyroid gland, exclude coagulopathy and pelvic diseases. Office and even portable hysteroscopy is a modern method of visual diagnosis of AUB. Techniques for hysteroscopic removal of intrauterine pathological formations include curettage under the control of a hysteroscope, removal with forceps or laser, hysteroresectoscopy, intrauterine morcelation. Office hysteroscopy can successfully detect and treat polyps, leiomyomas, isthmocele, chronic endometritis, hyperplasia. AUB is often accompanied by iron deficiency anemia (IDA). In severe cases or in the case of planned surgical interventions, IDA require treatment with intravenous iron preparations. Clinical data show that patients with preoperative anemia treated with iron preparations before surgery do not require blood transfusions in the postoperative period. Sufer (“Yuria-Pharm”) is a trivalent iron for intravenous administration. The dose is calculated individually for each patient based on the level of hemoglobin and the severity of iron deficiency. In case of severe blood loss during the operation, it is advisable to use tranexamic acid (Sangera, “Yuria-Pharm”), which is 10 times more effective than ethamsylate and 26 times – than aminocaproic acid. In a multicenter, randomized, double-blind, placebo-controlled WOMAN study of 20,000 women with postpartum haemorrhage, tranexamic acid reduced fatalities by more than 30 % and the need for urgent surgery for hemostasis by more than 35 %.
 Conclusions. 1. AUB can have different etiology, which largely depends on the age of the patient. 2. Office hysteroscopy is a promising method of visualization diagnosis and treatment of AUB. 3. Intravenous iron preparations can be used to correct anemia after AUB, and tranexamic acid – to stop an excessive bleeding.
24
Jain, Mahima, K. Bharathi, and Poonam Choudhary. "PREVENTION OF HYSTERECTOMY BY AYURVEDIC MANAGEMENT OF ASRUGDARA WITH CYSTIC GLANDULAR HYPERPLASIA: A CASE REPORT." June 2024 12, no. 6 (2024): 1121–25. http://dx.doi.org/10.46607/iamj1612062024.
Full textAbstract:
Asrugdara is a condition where there is an occurrence of heavy menstrual bleeding. Excess intake of food, which are excessive Lavana(salty), Amla(sour), Guru(heavy), Katu(hot), Vidahi (producing a burning sensation) and Snigdha (unctuous) etc. leads to this condition. This condition can be correlated with abnormal uterine bleeding (AUB). Abnormal uterine bleeding is defined as any uterine bleeding outside the normal volume, dura-tion, regularity or frequency is considered as abnormal uterine bleeding (AUB). This is a case report of a 41-year-old female patient having complaint of heavy menstrual bleeding with passing of clots for 11 days and ir-regular and early menses for three months. Her ultrasonography report was suggestive of thickened endometrial thickness with chronic cervicitis and a left ovarian simple cyst. She underwent conventional treatment of heavy bleeding, including Dilatation and Curettage (D&C), but was unsuccessful. The histopathology report suggested glandular cystic hyperplasia without atypia. In the allopathic system of medicine, hysterectomy is advised. The patient is diagnosed with Kapha Vataja Asrugadara as per the symptoms. The objective of the present treatment included Ayurvedic management of Asrugadara, ensuring a decrease in the menstrual blood flow and regulariza-tion of the cycle, thereby improving the patient's general condition. The treatment plan included Shamana Chikitsa along with Basti Chikitsa. The treatment outcome was completely relieved of the symptoms with a reg-ular ultrasonography report.
25
Silva, Cátia, Cristina Monteiro, Fernando Barbosa, Inês Cunha, Rosália Coutada, and Agostinho Carvalho. "Colouterine Fistula as a Rare Cause of Postmenopausal Abnormal Uterine Bleeding: A Case Report." Journal of Clinical Medicine 13, no. 3 (2024): 783. http://dx.doi.org/10.3390/jcm13030783.
Full textAbstract:
Postmenopausal abnormal uterine bleeding is a common clinical problem addressed in gynaecological practice and should prompt clinical investigation due to the significant prevalence of malignant and premalignant lesions of the endometrium in this age group. Nevertheless, other causes should be considered, since its diagnostic and therapeutic management may differ considerably. Here, we present a case of a colouterine fistula due to chronic diverticulitis presenting with postmenopausal abnormal uterine bleeding. This is an infrequent occurrence and is caused by the rupture of a diverticular abscess into the uterine wall, resulting in an inflammatory adhesion of the colon and uterus, with necrosis and subsequent fistula formation. The clinical presentation is variable and may include abdominal pain, gastrointestinal tract symptoms, vaginal discharge, and abnormal uterine bleeding. The laboratory and imaging techniques may be not completely conclusive and definitive diagnosis can be made intraoperatively. There are different treatment options, with en bloc resection and primary anastomosis being used most often, allowing complete treatment. The prognosis for a colouterine fistula secondary to diverticulitis is excellent after surgery. This case highlights the importance of clinical suspicion of an unusual cause of uterine bleeding and an effective and multidisciplinary approach that allowed complete surgical treatment and patient recovery.
26
Mishina, A., A. Kazakova, O. Lineva, et al. "ABNORMAL UTERINE BLEEDING IN PUBERTAL GIRLS, MANAGEMENT TACTICS." ASJ 1, no. 49 (2021): 28–31. http://dx.doi.org/10.31618/asj.2707-9864.2021.1.49.104.
Full textAbstract:
Abnormal uterine bleeding (AMC) is one of the most common pathologies of the reproductive system in girls of the pubertal period, which is certainly a medical and social problem. The solution of this issue has been relevant for many years, the main area of which is the development of preventive, diagnostic and therapeutic measures. The aim of the study was to study the features of the clinical picture of pubertal AMC, assessing the effectiveness of therapy. The study involved 140 girls from the city of Togliatti aged 10 to 15 years, who underwent a full clinical examination, assessment of psychological status, excluded chronic somatic diseases and diseases associated with a violation of the hemostasis system, sexual development according to Tanner corresponded to age norms. Two groups were formed: the first 30 girls diagnosed with abnormal uterine bleeding, who were on inpatient treatment, 110 girls received outpatient therapy. It has been established that AMCs are recurrent, which certainly requires preventive measures. The method of hemostasis in AMC should be selected individually, depending on the severity of bleeding and the characteristics of the clinical course. Antianemic therapy is necessary for all patients with signs of ZHD depending on severity, choosing the routes of administration of the drug, the duration of therapy.
27
Alekseeva, O. S., and V. V. Lazurenko. "Peculiarities of Somatic and Gynecological Status of Women with Abnormal Uterine Bleeding with Autoimmune Thyroiditis." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 6 (2022): 62–69. http://dx.doi.org/10.26693/jmbs07.06.062.
Full textAbstract:
The purpose of the study was to determine the peculiarities of somatic and gynecological status of women with abnormal uterine bleeding, who have autoimmune thyroiditis. Materials and methods. 120 women of reproductive age, of whom there were 90 patients with abnormal uterine bleeding and 30 women without gynecological pathology (control group), were examined. Patients from the main group were divided into 2 clinical groups: 60 women with autoimmune thyroiditis were included in the main group and 30 women without signs of thyroid gland pathology made up the comparison group. The research was conducted and the results of anamnestic data, somatic and gynecological status, clinical laboratory and ultrasound examinations, conservative and operative treatment were analyzed. The study was conducted in the gynecological department of the Communal Non-Commercial Enterprise of the Kharkiv Regional Council “Kharkiv Regional Clinical Hospital” during 2019-2022. Statistical processing of the obtained data was performed using the “Statistica 6.0” program. Results and discussion. As a result of the analysis of the anamnesis data of the patients of the main group, a hereditary predisposition to thyroid gland diseases was revealed in the closest relatives of every fifth patient with autoimmune thyroiditis. Among the concomitant gynecological pathology, such diseases as uterine leiomyoma, endometriosis of various localization, endometrial hyperplasia were more common in patients with uterine bleeding in combination with autoimmune thyroiditis (38.3%). In addition, fibrocystic mastopathy was also observed almost twice as often in patients with abnormal uterine bleeding against the background of autoimmune thyroiditis (25%) than in the group without thyroid gland pathology, which may be due to the hormonal dependence of the above-mentioned diseases, and is a predictor of the development of hereditary endocrine dysfunction and greater susceptibility of the reproductive system to exogenous and endogenous factors. When studying the somatic status of patients with abnormal uterine bleeding in combination with autoimmune thyroiditis, a significant prevalence of comorbid somatic pathology was noted. Among women with 2-3 concomitant diseases, the following combinations were most common: hypertension and obesity (13%); hypertension, chronic pancreatitis, varicose veins of the lower extremities (7%), chronic pyelonephritis, fibrocystic mastopathy. Every third patient had a combination of obesity, liver disease, and hypertension. It should be noted that in women with abnormal uterine bleeding without autoimmune thyroiditis, the accompanying pathology was twice as low as in the group suffering from the specified thyroid disease. Menstrual cycle disorders of various nature were detected. Irregular menstrual cycle occurred twice as often in women with abnormal uterine bleeding against the background of autoimmune thyroiditis than in women without concomitant thyroid disease – in 8 (13.3%) and 2 (6.7%) women, respectively. The analysis of the peculiarities of the generative function allowed to reveal a statistically significant predominance of women with primary infertility (13.3%). Secondary infertility occurred almost twice as often and was diagnosed in 20% of women. Almost every third woman with abnormal uterine bleeding and autoimmune thyroiditis had a history of reproductive loss (35%). In 16.7% of patients, habitual miscarriage was revealed. 3.33% had a history of ectopic pregnancy. Conclusion. The analysis of somatic diseases in women with autoimmune thyroiditis demonstrates their influence on the development of gynecological pathology, especially menstrual cycle disorders, in particular abnormal uterine bleeding, which requires the search for new approaches to their treatment and prevention
28
Lazareva, L. M., A. V. Atalyan, L. V. Belenkaya, et al. "Menstrual dysfunction in women of reproductive age belonging to major ethnic groups in Eastern Siberia: a cross-sectional study." Fundamental and Clinical Medicine 8, no. 2 (2023): 42–52. http://dx.doi.org/10.23946/2500-0764-2023-8-2-42-52.
Full textAbstract:
Aim. To determine the prevalence and features of menstrual dysfunction in premenopausal women of various ethnicities inhabitating Eastern Siberia.Materials and Methods. We conducted a cross-sectional study which included women of reproductive age (18-44 years) living in the Irkutsk region and the Republic of Buryatia. Out of 1134 women, 715 (63.1%) were Caucasians, 312 (27.5%) were Asians (Mongoloid), and 107 (9.4%) were of mixed ethnicity. The data have been collected during the annual physical examination carried out between March 2016 to May 2021,Results. The average age of menarche onset was 13.3 ± 1.4 years and did not differ significantly in Caucasians, Asians, and group of mixed ethnicities. The most frequent ages for menarche were 11 and 15 years among women of mixed ethnicity and Asians, respectively. Chronic abnormal uterine bleeding and dysmenorrhea was detected in 573/1134 (50.5%) and in 280/1134 (24.7%) of the examined women, respectively, without significant differences between the ethnicities. However, dysmenorrhea symptoms were more severe in Caucasians as compared to Asian women.Conclusion. The most frequent variant of menstrual dysfunction is chronic abnormal uterine bleeding. There were no significant differences in the prevalence of irregular menstrual cycles, oligo/anovulation, chronic abnormal uterine bleeding, and dysmenorrhea in women of reproductive age belonging to different ethnicities, although clinical manifestations of dysmenorrhea were most pronounced in Caucasians.
29
-. "Resolution of the 1st Ukrainian expert forum on abnormal uterine bleeding." REPRODUCTIVE ENDOCRINOLOGY, no. 62 (December 29, 2021): 64–74. https://doi.org/10.18370/2309-4117.2021.62.64-74.
Full textAbstract:
The menstrual cycle is an important indicator not only of the female reproductive system health but also an integral part of women's health. The issues of therapeutic approaches for menstrual disorders, considering the general trend towards an increase in the proportion of this pathology among the total gynecological disorders in Ukraine, are susceptible and require close attention. The problem of abnormal uterine bleeding (AUB) has a significant impact on women and health care worldwide. Algorithms for the diagnosis and therapy of AUB need to be regularly revised as international recommendations are updated, clinical trials are published, and a new look at pathogenetic mechanisms is made. The prerequisites for holding of this Expert Forum were the updating of the FIGO classification of uterine bleeding in 2018, the NICE guidelines “Heavy menstrual bleeding: assessment and management” in 2018 and 2021, as well as the new conditions of the pandemic era, which has taken its toll on the care of patients with AUB. The Resolution summarized all data unaccounted for in the current clinical protocol for AUB issued in 2016 and updated data from international guidelines and key studies in patients with AUB; highlighted in detail current thinking on the pathogenetic therapy of functional AUB, with an emphasis on chronic AUB associated with ovulatory dysfunction (AUB-O) and endometrial disorders (AUB-E), as the most common; provided modern approaches to the management of chronic AUB associated with non-structural causes (ovulatory dysfunction and endometrial factors), and prevention of acute AUB for implementation in clinical practice and improving the provision of evidence-based medical care and individualized patient care. The Resolution aims to optimize clinical approaches to patient management and ensure therapy personalization, which together will improve the reproductive health and general well-being of Ukrainian women.
30
Zhao, Shan, Li Yan, Zhiyi Zhao, Ming Hou, and Fengnian Rong. "Laparoscopic hysterectomy in chronic renal failure patients with abnormal uterine bleeding." Minimally Invasive Therapy & Allied Technologies 28, no. 1 (2018): 41–45. http://dx.doi.org/10.1080/13645706.2018.1467459.
Full text
31
Bagherinia, Marzieh, Farzaneh Safajou, and Zahra Amouzeshi. "Role of Chronic Stress in Abnormal Uterine Bleeding Leading to Hysterectomy." Journal of Surgery and Trauma 12, no. 4 (2024): 127–28. https://doi.org/10.61186/jsurgtrauma.12.4.127.
Full text
32
Cramer, Stewart F., and Debra S. Heller. "A Review and Reconsideration of Nonneoplastic Myometrial Pathology." International Journal of Surgical Pathology 26, no. 2 (2017): 104–19. http://dx.doi.org/10.1177/1066896917748194.
Full textAbstract:
From 1861 to 1962, clinicopathologic research tried to explain the association of abnormal uterine bleeding with uterine enlargement. The etiology was theorized as metropathy, suggesting that myometrial dysfunction may predispose to abnormal uterine bleeding. Research reached a nadir in 1962, when a major review dismissed myometrial hypertrophy as a plausible explanation after prior rejections of the theories of chronic myometritis, fibrosis uteri, and subinvolution as causes of bleeding. Subsequent to this arose a crusade against unnecessary hysterectomies in the 1970s. Although myometrial hyperplasia was proposed in 1868, it is only in the past 25 years that tangible evidence has supported that idea. It now appears that clinically enlarged uteri are due to globoid outward bulging of the uterus, caused by increased intramural pressure—often unrelated to either uterine weight or myometrial thickness. Abnormal (dysfunctional) uterine bleeding may often be due to spontaneous rupture of thrombosed dilated endometrial vessels, due to the combined effects of obstructed venous drainage by increased intramural pressure, and Virchow’s triad. Despite a century-old known association of parity with naturally occurring outer wall myometrial scars (fibrosis uteri with elastosis), it was not previously suggested that these may reflect healing reactions to muscle tears during labor and delivery. We now suggest that smaller, similar inner wall elastotic scars in the nerve-rich inner myometrium may explain many cases of pelvic pain. This review suggests that diverse pressure-related lesions may be present in clinically abnormal uteri that have been called “normal” since the crusade against unnecessary hysterectomy.
33
Urbina Alvarez, Claudia Aracelli, and Sonia Adelaida Pereyra López. "Actinomyces endometritis in an adolescent girl: a case report." Revista de Obstetricia y Ginecología de Venezuela 84, no. 03 (2024): 335–38. http://dx.doi.org/10.51288/00840315.
Full textAbstract:
Pelvic actinomycosis is a rare infection of the lower genital tract and pelvis. The most common causative species is the bacterium Actinomyces israelii, and it should be suspected in any patient who presents with chronic pelvic pain and uterine bleeding. Although it occurs exceptionally in women without a history of carrying intrauterine devices, it is important to consider it as a diagnosis. It is presented the clinical case of a 12-year-old patient with abnormal uterine bleeding resistant to treatment, which required surgical intervention, including endometrial biopsy. The resulting diagnosis was endometrial actinomycosis. This case contributes to updating knowledge about this rare disease and its uncommon presentation in adolescents. Keywords: Actinomycosis, Endometritis, Adolescent, Uterine Bleeding (DeCS/MeSH).
34
Bakhtiyarov, K. R., I. V. Ignatko, A. K. Isaev, and E. A. Samoilov. "Pharmacotherapy in patients with adenomyosis." Voprosy ginekologii, akušerstva i perinatologii 23, no. 4 (2024): 102–6. https://doi.org/10.20953/1726-1678-2024-4-102-106.
Full textAbstract:
This article presents a literature review on the problem of pharmacotherapy for adenomyosis. A comparative analysis of the efficacy of various hormonal agents was performed. The article emphasizes the advantages of dienogest (Alvovizan), which effectively relieves clinical symptoms of adenomyosis such as dysmenorrhea, chronic pelvic pain, and heavy menstrual bleeding. Compared to levonorgestrel-releasing intrauterine system (LNG-IUS), dienogest significantly faster reduces the severity of pain syndrome and shortens the duration of abnormal uterine bleeding. Menstrual cycle normalization was noted with dienogest and combined oral contraceptives (COCs), but dienogest was more effective. In a comparative analysis of ovarian volumes, it was recorded that there was a significant decrease in ovarian size in both comparison groups. Conclusion. Dienogest (Alvovizan) is an effective medication for pain relief in adenomyosis. It promotes uterine volume reduction, which significantly improves the quality of life of patients. Abnormal uterine bleeding is effectively controlled by this medication. Key words: adenomyosis, dienogest, Alvovizan, combined oral contraceptives, levonorgestrel-releasing intrauterine system, gonadotropin-releasing hormone agonists
35
Burka, O. A., A. V. Shumytskyi, and T. M. Tutchenko. "The role of laboratory tests in the evaluation of abnormal uterine bleeding causes." HEALTH OF WOMAN, no. 3(139) (April 30, 2019): 49–52. http://dx.doi.org/10.15574/hw.2019.139.49.
Full textAbstract:
The article presents an analysis of data from the revision of the classification system of abnormal uterine bleeding (AUB) carried out by FIGO in 2019. According to this classification system, there are 9 groups of etiological factors of AUB, divided into 2 categories: mainly structural (polyp, adenomyosis, uterine myoma, malignant processes) and mainly functional (coagulopathy, ovulatory dysfunction, endometrial pathology, unclassified causes). This is characterized by the prevalence of certain causes in different age periods of the life of women, often a combination of several causes is present. Contemporary possibilities of laboratory diagnostics of ovulatory dysfunctions, as well as endometrial pathologies, in particular chronic endometritis as often underestimated cause of AUB, are considered in detail. Key words: AUB, ovulatory dysfunction, chronic endometritis, immunohistochemistry, CD138, sexually transmitted diseases.
36
Fedosiuk, K. V. "The psycho-functional state of women with abnormal uterine bleeding and chronic stress." Reproductive health of woman, no. 7-8 (November 1, 2021): 63–65. http://dx.doi.org/10.30841/2708-8731.7-8.2021.250836.
Full textAbstract:
The objective: a study the levels of anxiety and stress in women with abnormal uterine bleeding (AUB) and chronic psycho-emotional stress. Materials and methods. We examined 100 women of reproductive age with AUB and chronic stress (basic group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis according to the order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The level of stress was assessed on Reeder stress scale, anxiety – scale of the Spielberger State-Trait Anxiety Inventory.Results. It was found that the mean trait anxiety score in all groups of women corresponded to the middle level, however, in patients with AUB and chronic stress, this indicator (44.07±1.05 points) was significantly higher than in the other two groups (40.08±1.20 points – in the comparison group and 37.80±1.29 – control group). The level of state anxiety in patients with AUB and chronic stress was high (48.15±0.85 points) and significantly more (p<0.001) relative to the patients with AUB without chronic psycho-emotional stress (42.42±1.21 points) and healthy women (39.80±1.43 points). The largest number of women with a high level of state anxiety was found in the basic group (58.00%, p=0.03) relative to the control group (33.33%). The mean of the stress level in patients with AUB and chronic stress was 2.11±0.05 points and was significantly less (p<0.001) relative to healthy women (2.94±0.09 points) and patients with AUB without chronic stress (2.88±0.05 points). A high level of stress was found in more than one third of patients in the basic group (37.00%) versus absence of such persons in the control and comparison groups (p<0.001). Conclusions. In women of reproductive age with AUB and chronic stress, there is an increase in the level of state anxiety and stress.
37
Acharyya, Tanaya, Soumya Sankar Paul, and Hemkanta Dev Sarma. "A rare case of abnormal uterine bleeding in a perimenopausal woman with chronic uterine inversion caused by extrusion of benign fundal submucosal fibromyoma." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 11 (2022): 3197. http://dx.doi.org/10.18203/2320-1770.ijrcog20222820.
Full textAbstract:
Uterine inversion secondary to a pathological process of the myometrium is very rare. We report the case of a 48-year-old woman presenting with abnormal uterine bleeding (AUB) and mass like sensation in vaginal canal, in whom a study by MRI demonstrated a uterine inversion with submucosal pedunculated leiomyoma. She had undergone total abdominal hysterectomy (TAH) and ovaries were preserved bilaterally.
38
K.V., Fedosiuk. "ASSESSMENT OF VITAMIN D LEVEL IN WOMEN WITH ABNORMAL UTERINE BLEEDING AND CHRONIC PSYCHOGENIC STRESS." Reproductive Health of Woman, no. 1 (March 23, 2022): 14–17. https://doi.org/10.30841/2708-8731.1.2022.258131.
Full textAbstract:
<strong>The objective:</strong> to study the level of vitamin D (25-hydroxycalciferol – (25(OH)D) in blood serum of women with abnormal uterine bleeding (AUB) and chronic psychogenic stress. <strong>Materials and methods.</strong> We examined 100 women of reproductive age with AUB and chronic psychogenic stress (basic group) and 50 patients with AUB without psychogenic chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. AUB was diagnosis according to the Order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentration of vitamin D was determined in blood serum in all the women using the ELISA method. <strong>Results.</strong> The concentration of vitamin D in the blood serum in patients with AUB and chronic psychogenic stress was on 28.01 % lower compared to the controls (p < 0.001), in the patients with AUB without psychogenic chronic stress – 13.94 % (p = 0.045). The number of individuals with optimal concentration of vitamin D in the control group (36.67 %) was in 2.29 times higher compared to the basic group (16.00 %; p=0.03) and in 1.41 times more compared to the comparison group (26.00 %). Suboptimal level of vitamin D had 53.33 % women in the control group, 43.00 % – basic and 58.00 % – comparison one. The rate of persons with deficiency of vitamin D among the patients with AUB and chronic psychogenic stress was in 4.56 times higher compared to the healthy women (41.00 % and 9.00 % individuals, respectively; p = 0.003), and in patients with AUB without chronic stress –1.78 time (16.00 % women). <strong>Conclusions.</strong> There is the insufficient vitamin D concentration in women with abnormal uterine bleeding which is more severe in the persons with chronic psychogenic stress.
39
Fedosiuk, K. V. "Assessment of hormonal homeostasis in women with abnormal uterine bleeding and chronic stress." Reproductive health of woman, no. 9-10 (December 30, 2021): 39–41. http://dx.doi.org/10.30841/2708-8731.9-10.2021.252587.
Full textAbstract:
The objective: to study the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones, testosterone, prolactin and cortisol in women with abnormal uterine bleeding (AUB) and of chronic psycho-emotional stress.Materials and methods. We examined 100 women of reproductive age with AUB and chronic stress (main group) and 50 patients with AUB without chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. The AUB diagnosis was made on the basis of order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentrations of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin and cortisol were determined in blood serum in all the women in the follicular phase of the menstrual cycle using the ELISA method.Results. In patients with AUB and chronic stress, a significant decrease of estradiol by 37.50% relative to healthy women, FSH – 44.42%, LH – 22.12%, progesterone – 38.23% and a significant increase in prolactin by 41.92% and cortisol – 82.96% were established. In the patients with AUB without chronic stress a significant decrease in estradiol level by 23.95%, FSH by 22.09% and progesterone by 21.91%, and a significant increase in cortisol by 21.55% were found. The concentration of testosterone in the main group and the comparison group, as well as changes in the levels of LH and prolactin in the patients of the comparison group, were insignificant relative to the control group. Conclusions. In women of reproductive age with abnormal uterine bleeding and chronic stress, there is a significant decrease in the concentration of estradiol, progesterone, follicle-stimulating and luteinizing hormones in the blood serum, an increase of prolactin and cortisol, and the absence of significant changes in testosterone level in the follicular phase of the menstrual cycle.
40
Gupta, Sumedha, Saloni Chadha, Dheer Singh Kalwaniya, and Bhawuk Dhir. "Rare occurrence of adenocarcinoma in an endocervical polyp: diagnostic and clinical challenges." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 13, no. 11 (2024): 3371–73. http://dx.doi.org/10.18203/2320-1770.ijrcog20243210.
Full textAbstract:
Endocervical polyps, typically benign, are frequently discovered during routine gynecological examinations, although they may present with abnormal uterine bleeding or increased vaginal discharge. Malignant transformation within these polyps is rare, with an estimated incidence ranging from 0.0% to 1.7%. We present a case of a 38-year-old premenopausal woman who exhibited secondary infertility and abnormal uterine bleeding, eventually diagnosed with invasive adenocarcinoma within an endocervical polyp. Diagnostic evaluations including histopathology and imaging confirmed deep infiltrating endometriosis and uterine adenomyosis. Following multidisciplinary consultation, the patient underwent a cone biopsy, which revealed chronic cervicitis. Ultimately, a hysterectomy with bilateral salpingo-oophorectomy was performed. The final histopathology revealed leiomyoma and endometriosis, with no malignancy beyond the polyp. This case highlights the diagnostic challenges associated with malignancies within cervical polyps and underscores the importance of excising and thoroughly examining such polyps, even when cytological findings are negative.
41
Amir, Sahar Salahuddin, and Aman-ur Rehman. "Pipelle Endometrial Sampling and Morphological Findings in Women with Abnormal Uterine Bleeding." Pakistan Journal of Medical and Health Sciences 16, no. 11 (2022): 299–301. http://dx.doi.org/10.53350/pjmhs20221611299.
Full textAbstract:
Background: The abnormal uterine bleeding has many causes and consequences in women. The exact causes are described by histology of sample through D&C. Pipple biopsy samples is considered one of the least invasive, OPD setting technique, comparable to D&C. Objective: To see the adequacy of Pipelle endometrial sampling and morphological findings among women with abnormal uterine bleeding. Study Design: Cross-sectional descriptive study Place and Duration of Study: Department of Gynaecology & Histopathology, Shaikh Zayed Hospital Lahore from 1st May to 31st December 2021. Methodology: Two hundred and thirty seven adult women with AUB recommended for D&C were included. Those with endometrial thickness less than 4mm, having fibroids, with pelvic inflammatory disease, or clotting factor disorders were excluded. Pipelle endometrial sample was taken in Gyne OPD and were examined at Histopathology Department. Results: 80.0% were sampled adequately through Pipelle. Secondary endometrium was most common in 39.9% followed by proliferative endometrium in 36.2% and chronic endometritis 12.2%. There were 6 cases with carcinoma, 4 (2.1%) with adenocarcinoma and 2(1.1%) squamous cell carcinoma. Conclusion: Pipelle Endometrial sampling can be considered an effective methods for endometrial sampling. Keywords: Abnormal uterine bleeding, Pipelle endometrial biopsy, Sample adequacy, Endometrial pathology
42
Manjari and Kumar Rajendra. "Histopathological Study of Endometrium in Abnormal Uterine Bleeding Patients in Tertiary Care Hospital of South West Bihar." International Journal of Pharmaceutical and Clinical Research 13, no. 5 (2021): 35–42. https://doi.org/10.5281/zenodo.14212716.
Full textAbstract:
<strong>Background: </strong>Endometrium is sensitive to sex hormones and abnormal uterine bleeding is prevalent in all age group females which cause anemia and affects quality of life. Pattern of endometrial pathology diagnosis is vital to know the proper cause of bleeding to maintain clinicians conversant in making their management strategy. <strong>Methods: </strong>Study of endometrial biopsy was done retrospectively for a period of 1 ½ years. After processing of tissues, slides stained with hematoxylin & eosin by conventional method was examined microscopically. A statistical analysis between endometrial histopathology and mean age of presentation was done using Chi square test. <strong>Results: </strong>After exclusion due to various reasons, 197 samples were enlisted for reviewing and final diagnosis was made. Endometrial hyperplasia emerged the commonest with 29.4% mostly in reproductive age group, followed by proliferative endometrium 20.3%, atrophy endometrium 16.24%, chronic endometritis 9.64%, endometrial polyp 8.63%, disordered proliferative endometrium 7.61% and secretory endometrium 6.6%. The endometrial carcinoma was diagnosed in only 1.52% of cases mostly in postmenopause females. The menorrhagia was the most common complaint overall (48.2%). <strong>Conclusion: </strong>The D & C method is suitable, but a newer technique has more scope. The commonest endometrial pathology in this study came out to be endometrial hyperplasia. For that unplanned use of hormone therapy is to be avoided.
43
Lonky, Neal M., Vicki Chiu, Cecilia Portugal, et al. "Adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding associated with uterine leiomyomas." PLOS ONE 18, no. 12 (2023): e0294925. http://dx.doi.org/10.1371/journal.pone.0294925.
Full textAbstract:
Background Uterine leiomyomas and adenomyosis are both common and often associated with abnormal uterine bleeding (AUB), including the symptom of heavy menstrual bleeding (HMB). Understanding the prevalence of adenomyosis in women with uterine leiomyomas could inform clinicians and patients in a way that may improve therapeutic approaches. Objective To explore the prevalence of adenomyosis in a group of women who underwent hysterectomy for AUB-L, to determine the prevalence of submucous leiomyomas, and to examine the utility of preoperative ultrasound to detect the presence of adenomyosis. Methods The Kaiser Permanente Hysterectomy Database (KPHD) was searched for women aged 18–52 undergoing hysterectomy for leiomyoma-associated chronic AUB (AUB-L) in 2018 and 2019. A target sample of 400 comprised those with at least 3 years in the Health System. Radiologists evaluated preoperative pelvic ultrasound images to determine leiomyoma size and level 2 FIGO type (submucous or other), and the linked electronic medical record abstracted for clinical features, including histopathological evidence of adenomyosis. Results Of the 370 subjects that met the study criteria, adenomyosis was identified via histopathology in 170 (45.9%). There was no difference in the adenomyosis prevalence with (47.1%) and without (43.0%) at least one submucous leiomyoma. Subgroup analysis of ultrasound images by an expert radiologist for the presence of adenomyosis demonstrated a positive predictive value of 54.0% and a negative predictive value of 43.4%. Conclusions Adenomyosis was present in almost half of this AUB-L cohort undergoing hysterectomy and was equally prevalent in those with and without submucous leiomyomas as determined by sonographic evaluation. The imaging findings are in accord with prior investigators and demonstrate that 2-D ultrasound is insensitive to the presence of adenomyosis when the uterus is affected by leiomyomas. Further research is necessary to determine the impact of various adenomyosis phenotypes on the presence and severity of the symptom of HMB.
44
Yuvarani, Yuvarani, Logeswari Logeswari, and Rashmi Thakur. "A Case Report of Parasitic Bladder Infestation in Woman with Abnormal Uterine Bleeding." EAS Journal of Anaesthesiology and Critical Care 5, no. 03 (2023): 45–46. http://dx.doi.org/10.36349/easjacc.2023.v05i03.002.
Full textAbstract:
Detection of urinary parasites is a relatively rare and incidental finding. Chronic parasitic infections lead to a state of chronic inflammation and cytokine release which is also a risk for tumor cell development. It also causes anemia which makes a patient susceptible to infections and further morbidity. In this case, a woman presented with AUB-L with recurrent urticarial lesions leading to lichen simplex complex and severe anemia and patient on cystoscopic examination showed parasitic infestation of bladder.
45
-. "Resolution of the 1st Ukrainian expert forum on abnormal uterine bleeding." REPRODUCTIVE ENDOCRINOLOGY, no. 62 (December 29, 2021): 64–74. http://dx.doi.org/10.18370/2309-4117.2021.62.64-74.
Full textAbstract:
The menstrual cycle is an important indicator not only of the female reproductive system health but also an integral part of women's health. The issues of therapeutic approaches for menstrual disorders, considering the general trend towards an increase in the proportion of this pathology among the total gynecological disorders in Ukraine, are susceptible and require close attention. The problem of abnormal uterine bleeding (AUB) has a significant impact on women and health care worldwide. Algorithms for the diagnosis and therapy of AUB need to be regularly revised as international recommendations are updated, clinical trials are published, and a new look at pathogenetic mechanisms is made.The prerequisites for holding of this Expert Forum were the updating of the FIGO classification of uterine bleeding in 2018, the NICE guidelines “Heavy menstrual bleeding: assessment and management” in 2018 and 2021, as well as the new conditions of the pandemic era, which has taken its toll on the care of patients with AUB.The Resolution summarized all data unaccounted for in the current clinical protocol for AUB issued in 2016 and updated data from international guidelines and key studies in patients with AUB; highlighted in detail current thinking on the pathogenetic therapy of functional AUB, with an emphasis on chronic AUB associated with ovulatory dysfunction (AUB-O) and endometrial disorders (AUB-E), as the most common; provided modern approaches to the management of chronic AUB associated with non-structural causes (ovulatory dysfunction and endometrial factors), and prevention of acute AUB for implementation in clinical practice and improving the provision of evidence-based medical care and individualized patient care.The Resolution aims to optimize clinical approaches to patient management and ensure therapy personalization, which together will improve the reproductive health and general well-being of Ukrainian women.
46
S., Anitha, Pooja G., and Sowmya D. "Study of histopathological patterns of endometrium in abnormal uterine bleeding." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 4 (2021): 1401. http://dx.doi.org/10.18203/2320-1770.ijrcog20211110.
Full textAbstract:
Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out- patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. And also, to observe the incidence of various endometrial pathology in different age groups presenting with abnormal uterine bleeding.Methods: A one-year prospective study conducted in the department of obstetrics and gynaecologist in A. J. institute of medical sciences and research centre which included 200 cases of clinically diagnosed AUB patients. Histopathological examination of endometrial biopsies specimens was done, followed by clinical correlation.Results: The most common age group presenting with AUB was 41-50 years (43.84%). The commonest pattern in these patients was normal cycling endometrium (42.32%). The commonest pathology irrespective of the age group was disordered proliferative pattern (26.15%). Other causes identified atrophic endometrium (11.5%), benign endometrial polyp (5.38%), endometrial hyperplasia (5.41%), carcinomas (0.79%) and chronic endometritis (1.54%).Conclusions: The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 years; i.e., the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest.
47
Fedosiuk, K. V. "Assessment of vitamin D level in women with abnormal uterine bleeding and chronic psychogenic stress." Reproductive health of woman, no. 1 (March 23, 2022): 14–17. http://dx.doi.org/10.30841/2708-8731.1.2022.258131.
Full textAbstract:
The objective: to study the level of vitamin D (25-hydroxycalciferol – (25(OH)D) in blood serum of women with abnormal uterine bleeding (AUB) and chronic psychogenic stress.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress (basic group) and 50 patients with AUB without psychogenic chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. AUB was diagnosis according to the Order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentration of vitamin D was determined in blood serum in all the women using the ELISA method.Results. The concentration of vitamin D in the blood serum in patients with AUB and chronic psychogenic stress was on 28.01 % lower compared to the controls (p < 0.001), in the patients with AUB without psychogenic chronic stress – 13.94 % (p = 0.045). The number of individuals with optimal concentration of vitamin D in the control group (36.67 %) was in 2.29 times higher compared to the basic group (16.00 %; p=0.03) and in 1.41 times more compared to the comparison group (26.00 %). Suboptimal level of vitamin D had 53.33 % women in the control group, 43.00 % – basic and 58.00 % – comparison one. The rate of persons with deficiency of vitamin D among the patients with AUB and chronic psychogenic stress was in 4.56 times higher compared to the healthy women (41.00 % and 9.00 % individuals, respectively; p = 0.003), and in patients with AUB without chronic stress –1.78 time (16.00 % women).Conclusions. There is the insufficient vitamin D concentration in women with abnormal uterine bleeding which is more severe in the persons with chronic psychogenic stress.
48
Tkachenko, L. V., N. I. Sviridova, N. A. Zharkin, N. A. Burova, and E. B. Belan. "Assessing cytokine status of patients with chronic endometritis combined with endometrial hyperplastic processes in reproductive period." Russian Journal of Infection and Immunity 10, no. 4 (2020): 762–68. http://dx.doi.org/10.15789/2220-7619-aoc-1357.
Full textAbstract:
The goal of our study was to examine local and serum cytokine level involved in regulating inflammation in patients with chronic endometritis combined with endometrial hyperplastic processes. On admission, all patients underwent hysteroscopy with separate diagnostic curettage followed by histological examination of samples isolated from the uterine and cervical canal mucosa. Such manipulations were indicated due to abnormal uterine bleeding as well as suspected endometrial pathology based on ultrasound examination. According to the histological examination data of the endometrial samples, all patients were divided into two groups: group I contained 45 women with CE combined with PEG without atypia; group II — 38 patients with morphologically verified CEE combined with AEG without atypia. Level of IL-1P, IL-2, IL-6, IFNy, TNFa in biological fluids (aspirate from the uterus; serum) was measured by using enzyme-linked immunosorbent assay. We found that in both groups (91.1% and 89.6%, respectively) the vast majority of patients was hospitalized due to abnormal uterine bleeding. Oligomenorrhea alternated with intermenstrual bleeding (66.7% and 71.2%, respectively) and dominated in pattern of menstrual cycle disorders in the examined patients, whereas 11 (24.4%) and 7 (18.4%) patients from group I and II, respectively, were noted to suffer from severe menstrual bleeding. Overall, analyzing the data on cytokine level both in the uterine aspirate and serum evidences about ongoing inflammatory process found at examination time point. Upon that, such process was not only local, but also exhibited signs of a systemic inflammatory response. The data on cytokine level in the uterine aspirate from patients with CE coupled to PGE or CGE without atypia point at local inflammatory process characterized by significantly increased concentration of IL-ф, IL-2, IL-6, TNFa and IFNy. At the same time, higher level of IL-ф and IFNy in patients from group II might indicates that degree of morphological changes in the endometrium could affect the level of local cytokine production. Thus, the data obtained evidence that immune changes in chronic endometritis combined with non-atypical endometrial hyperplastic processes mostly occur locally. In this regard, measuring cytokine concentration in the uterine aspirate is a diagnostic predictor and serves as a sign for monitoring therapeutic effectiveness of therapy in this cohort of patients.
49
Fedosiuk, K. V. "The optimization of abnormal uterine bleeding treatment in women with chronic psychogenic stress." Reproductive health of woman, no. 2 (April 29, 2022): 29–32. http://dx.doi.org/10.30841/2708-8731.2.2022.261803.
Full textAbstract:
The objective: to assess the effectiveness of the complex optimized treatment approach to abnormal uterine bleeding (AUB) in women with chronic psychogenic stress on the quality of life.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress, 50 patients of them consisted the I group and received the optimized treatment, and 50 persons (II group) received the standard AUB treatment. 30 women without AUB and chronic stress were included in the control group. The examination of all persons included: anamnesis, clinical and gynecological examinations, ultrasound examination, general blood test, blood ferritin, vitamin D in serum blood. The quality of life was determined according to the 36-Item Short Form Health Survey before treatment and after three months. The standard approach included diagnostic and therapeutic measures according to the recommendations of Order N 353 dated 13.04.2016 of the Ministry of Health of Ukraine. The optimized treatment additionally included recommendations for lifestyle changes, melatonin, the use of vitamin D depending on its level, the medicament correction of iron deficiency without anemia.Results. The results of the questionnaire 36-Item Survey scales indicate that in patients with AUB and chronic psychogenic stress there is a decrease in the scales relative to the values of healthy women, especially in psychological component. In the persons of the II group there was no significant dynamics of the scales “Bodily pain” and “Physical role functioning” relative to the indicators before treatment, while the scales “Physical function” (p<0,001) and “General health perceptions” (p=0.01) increased significantly. The optimized treatment lead to a significant increase in all physical component scales compared till normal indices. In patients of the II group the indicators of psychological scales after treatment were significantly lower than the average values of healthy women. Thus, the value of the scale “Mental Health” was lower by 14,34% relative to the control group (p=0,18), “Emotional role functioning” – 18,38% (p=0,007), “Social role functioning” – 15,46% (p=0,003), “Vitality” – 23,27% (p=0,005). In the women of the I group there was a significant increase in the indicators of the psychological scales, which after treatment reached the values of healthy women.Conclusions. In women with AUB and chronic psychogenic stress, there is an insufficient positive dynamics in improving the quality of life after the standard treatment, especially the scales of the psychological component. The optimized treatment approach leads to the improvement of all parameters of quality of life of the patients.
50
Aleynikova, Ekaterina Yu, and Alina V. Solovyeva. "Uterine fibroids: modern methods of treatment, advantages and complications." RUDN Journal of Medicine 27, no. 1 (2023): 57–64. http://dx.doi.org/10.22363/2313-0245-2023-27-1-57-64.
Full textAbstract:
The state of the reproductive system by women with uterine fibroids is considered as a part of this literature review. The main clinical manifestations of myomatous nodes were identified by writing the review: abnormal uterine and heavy menstrual bleeding, infertility, miscarriage, chronic pelvic pain, dysfunction of adjacent organs, which are indications for surgical treatment. It is noted that approximately 30 % of women with uterine fibroids suffer from abnormal uterine bleeding, leading to anemia and reduced quality of life. Chronic pelvic pain significantly reduces the quality of life of patients, worsening their functional and mental state and disrupting sexual function. This review focuses on reproductive problems in women with leiomyoma. Taking into consideration the high prevalence of this nosology and the need to preserve the fertility of patients, the review describes modern methods of treating patients with uterine myoma, including drug therapy surgical treatment and alternative methods. Currently, in order to stop the symptoms of uterine fibroids, as well as for preoperative preparation, conservative therapy is used, which allows to reduce pain, restore hemoglobin levels, reduce intraoperative blood loss and reduce surgery time. Reproductive disorders associated with uterine fibroids, such as infertility, recurrent miscarriage, and adverse obstetric outcomes, are a significant reason to improve organ-preserving therapies or develop new ones. Although hysterectomy is a radical treatment for uterine fibroids, it is unacceptable for patients who have not realized their reproductive function. Therefore, the most justified intervention is myomectomy with various surgical approaches, and as an alternative treatment, uterine artery embolization, radiofrequency ablation or high-intensity focused ultrasound treatment of uterine fibroids. These data allow us to conclude that the high prevalence and versatility of symptoms of uterine fibroids among patients of reproductive age determine the relevance of searching for optimal methods of treatment.