ABSTRACT
Background:To correlate endometrium thickness(ET) measured by trans vaginal sonography (TVS) with their hysteroscopy finding along with histopathological diagnosis in patients of abnormal uterine bleeding.Methods: 120 patients of AUB in reproductive age group to post menopause were included in study. All were subjected for investigations including CBC,TSH,FBS and USG pelvis. Endometrial thickness was measured by TVS and were subjected for diagnostic Hysteroscopy(DH) . DH findings were noted as normal endometrium or abnormal findings . Endometrial curettage was performed in all patients and sample collected sent for histopathological study. Result: AUB was common in 41-50yrs age group and menorrhagia being the most common symptoms. The Prevalence of disease finding by DH ,its sensitivity and specificity were 46.6%,89.2% and 60.9% respectively. False positive rate and False Negative rate, positive predictivity ,negative predictivity, Calculated positive like hood ratio & negative likehood ratio were 39%,10.7%,86.2%,2.2 and 5.6 respectively with Diagnostic accuracy was 74.1%. Hysteroscopic diagnosis of polyp has sensitivity & specificity of 100% who presented with post menopausal bleeding. Carcinoma endometrium was diagnosed in 3 patients (13%) out of 23 case of PMBPV. Maximum number of normal endometrium were observed when ET<15mm while polyp and Ca endometrium when ET was >15mm.But Ca endometrium was also diagnosed when ET was in range of 5-10mm.When ET was<5mm the endometrium pattern observed were either normal or atrophic. Conclusion: It is concluded from our study that in all AUB cases ET can impose an idea of case selection for Hysteroscopic procedure and D&C combined with hysteroscopy is the gold standard evaluation.
ABSTRACT
Background:Pregnancy induced hypertension is an important cause of maternal and fetal morbidity and mortality affecting 5-10% of pregnancies.PIH is more frequently associated with elevated TSH. Hypothyroidism is one of the causes of hypertension in nonpregnant state. Hypertension is completely reversible in 50% cases of hypothyroidism by levothyroxine therapy. Treating hypothyroidism in pregnancy may help to reduce PIH prevalence. Objectives- This is an observational study to find out association of PIH with hypothyroidism and to know result of levothyroxine treatment on PIH prevalence and its severity. Methods: 75 singleton pregnancies with PIH admitted to labour ward, evaluated with their TSH status in groupA. In Group B, 75 singleton pregnancies with subclinical or overt hypothyroidism treated with levothyroxine to maintain euthyroid state throughout pregnancy and observed for development of PIH. Overt hypothyroidism considered when TSH value ≥10 and subclinical hypothyroidism when TSH value between 3 and 10.. Result: Overt and subclinical hypothyroidism was present in 12% (9 out of 75) and 57.3%(43 out of 75) cases of PIH respectively. In group B, all hypothyroid pregnancies treated with levothyroxine throughout pregnancy, prevalence of PIH was 6.66% (5 out of 75) . Significant association of PIH and hypothyroidism demonstrated by Fisher’s exact test (p<0.001). PIH prevalence significantly reduced in treatment group demonstrated by chi square test (p<0.001). Conclusion: Subclinical and overt hypothyroidism prevalence is significantly high among PIH patients. Treating subclinical and overt hypothyroidism in pregnancy, reduces prevalence of PIH and its severity.