Role of combined estrogen assay and histopathology in management of peri-menopausal uterine bleeding

Sixty patients were included in this study in whom perimenopausal bleeding was the main complaint. Abdominal hysterectomies were done depending on the results of previous endometrial biopsy and /or previous treatment trials. 5 ml of peripheral venous blood were taken before operation for total estrogen estimation. Postoperative hysterectomy specimens from the endometrium, myometrium and the ovaries were taken and examined for histopathological examination. The results of preoperative estrogen assay and endometrial histopathology have been correlated with the results of postoperative histopathological findings of the studied specimens. Statistical analysis indicated that patients with fibroid uterus and /or adenomyosis had a significantly higher estrogen level. Although estrogen levels were higher in cases of endometrial hyperplasia than that without hyperplasia, the difference in estrogen level between both categories is not statistically significant. Also, cases with functional ovarian cysts and ovarian stromal hyperplasia had a significantly higher estrogen level than cases with normal ovarian histology

Bacterial vaginosis in premature rupture of membranes

This study was carried out on 90 women. They were divided into 3 groups: 30 pregnant women with history of premature rupture of membranes and 30 pregnant women with intact membranes and 30 fertile, non pregnant women, during the intermenstrual period. A complete history was taken and physical examination was performed for all cases. The diagnosis of PRM was confirmed by a sterile dry speculum examination, PH estimation and crystallization test for the leaked fluid. Bacterial vaginosis was diagnosed in all women by gram's stain and clinical criteria. Bacterial vaginosis was diagnosed in 10 women with PRM [33.3%] by the gram's stain and in only 8 cases [26.6%] by the clinical criteria. Bacterial vaginosis was diagnosed in 8 pregnant women with intact membranes [26.6%] by gram's stain and in 9 cases [30%] by clinical criteria. Bacterial vaginosis was diagnosed in 8 fertile, non pregnant women [20%] by gram's stain and in 7 cases [23.3%] by clinical criteria. The present study showed no significant association between bacterial vaginosis and PRM. In women with PRM, the incidence of preterm delivery and low birth weight was 76.6%. In women with PRM, bacterial vaginosis was associated with preterm delivery in 23.3%. The incidence of postpartum endometritis in cases of PRM was 6.6% and in cases of PRM associated with bacterial vaginosis was 3.3%. The preterm neonates whose mothers had PRM had RDS, neonatal jaundice and intracranial hemorrhage in 46.6%, 53.3% and 6.6%, respectively