Abnormal uterine bleeding; hysteroscopic findings in patients

To determine the frequency of the various uterine pathologies detected during hysteroscopic examination in women with abnormal uterine bleeding. Descriptive - case series. This study was conducted at Nishtar Hospital Multan in the Department of Obstetrics and Gynaecology Unit II from July 2005 to July 2006. A total of 70 patients admitted through gynecology outpatient department with complaint of abnormal uterine bleeding were evaluated. 40 patients were selected by non- probability purposive sampling. Assessment included detailed history, clinical examination, baseline investigations and pelvic ultrasound in all patients. ECG and X-ray chest of patients above 40 years was done. Diagnostic hysteroscopies were performed and findings were noted. A total of 40 patients underwent diagnostic hysteroscopy. Most of the women were in perimenopausal age group with presenting complaint of irregular and heavy bleeding per vaginum. General anesthesia was used in all patients with saline as distension medium. Pathology was diagnosed in 52.5% with the help of hysteroscope. The most common pathology was endometrial polyp 27.5% followed by submucous fibroid 25%. No early or late complication was observed. Incidence of focal endometrial lesions in patients with AUB is high. Hysteroscopy provides direct visualization of endometrial cavity and hence accurately detects intrauterine pathology. It is safe, effective and successful investigation and should be considered a procedure of choice for evaluation of abnormal uterine bleeding

Aetiological factors and management of adolescents menorrhagia

To determine the frequency of the various causative factors of adolescent menorrhagia and assess the rate of success of various treatment in practice. A descriptive study. This study was conducted at Nishtar Hospital, Multan in the Department of Obstetrics and Gynaecology from November 2002 to November 2003. 125 adolescents with menorrhagia were interviewed. Amount of blood loss was determined by history of heavy bleeding associated with passage of clots or by bleeding extending beyond 7 days and by the presence of anemia. Seventy five married adolescents were excluded from the study and only fifty unmarried adolescents were followed. In majority of he adolescents [88%] there was no identifiable cause of problem and were labeled as a case of dysfunctional uterine bleeding [DUB]. 10% of the patients had underlying bleeding disorder. Genital tract pathology and endocrine disorders were rare causes [2%]. Combined oral contraceptive pills [COC pills] were the most popular among treatments and 75% of patients reported improvement. NSAIDs had a success rate of 60%. NSAIDs and antifibrinolytics gave a success rate of 83%. Patients who were carefully counseled and reassured reported subjective improvement in symptoms [60%]. Dysfunctional uterine bleeding is the most common cause of adolescent menorrhagia and detailed information for the problem and reassurance are very important. Combined oral contraceptives are very effective drugs for the treatment of adolescent menorrhagia