RESUMO
Objective: To determine the etiology and clinical profile of patients with abnormal uterine bleeding
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Shahina Jamil Teaching Hospital, Abbottabad from September 2014 to February 2016
Materials and Methods: Patients who were not pregnant, among the age of 20-60 years and had history of abnormal menstruation were included. Exclusion criteria included patients who were pregnant, less than 20 years or greater than 60 years, or suffering from cancer. Epidemiological data was noted and detailed history was taken especially about menses, vaginal discharge, use of drugs, hormonal treatment including oral contraceptive pills and any method of contraception used. Physical, ultrasonographic examination and histopathological examination of endometrium was performed in all patients
Results: There were 200 patients enrolled in this study. Their mean age was 38 +/- 5 years. Majority of them were between the age of 31-40 years, [82 patients] and 41-50 years, [66 patients].About 150 patients had menstrual irregularities. Eighty of these patients had menorrhagia while seventy had polymenorrhagia. Fifty patients had history of vaginal bleeding. Contraceptive measures were used by 38 patients. Out of which, OCPs were the preferred mode of contraception used. Twenty two patients had infertility with 16 had primary while 6 had secondary infertility. Sixty two patients had abnormal ultrasound examination. The chief ultrasonographic abnormality was that of uterine fibroid, ovarian cyst and ovarian cancer. On endometrial examination, 168 patients had normal physiological changes. The predominant change in this group was that of proliferative and secretory changes. Twenty patients had abnormal physiological endometrial changes. The chief abnormalities found were that of Pill endometrium, [12 patients] and irregular shedding, [4 patients]. Preneoplastic and inflammatory changes were observed in six patients in each group
Conclusion: AUB is one of the commonest gynecological disorders. The underlying cause can be determined by meticulous work-up in these patients which can help in deciding optimal treatment option for AUB patients. This, in turn, will not only improve health and well-being of these patients but as well as improve their quality of life. Endometrial sampling plays an important role in the diagnostic work-up of AUB. Therefore, it should be offered to all such patients as part of their evaluation