RESUMO
Background: Abnormal uterine bleeding (AUB) is any heavy or unusual bleeding from the uterus (through your vagina). It can occur at any time during your monthly cycle, including during your normal menstrual period. Aim: This study aimed to compare the accuracy of TVUS and SIS in relation to hysteroscopy in assessing the uterine cavity and in detecting ER and PR in endometrium and their relation with endometrial polyps in women with peri and postmenopausal bleeding. Materials and methods: The present study was a prospective study which included 120 patients with AUB who were attending the department of gynaecology at Gandhi Medical College, Hyderabad from July 2012 to November 2015. Results: 120 patients were selected in this study. Patients suffering from endometrial polyp were 40 (33.34%), endometrial hyperplasia were 25 (20.83%), endometrial atrophy were 19 (15.83%), normal endometrium were 19 (15.83%) and submucous fibroid were 17 (14.17%). Age was shown in mean±SD and p-value was 0.39 and it was statistically non- significant. Parity was shown in mean±SD and p-value was 0.283 and it was statistically non-significant. SIS had 4 false negative results by missing 2 cases with endometrial polyps, 4 false positive result by diagnosing a case of 4 endometrial hyperplasia as polypi. SIS had 8 false negative results (by missing 6 cases), 8 false Katadi Venkata Sudha Madhuri, Kolati Srinivas Rao. Uterine Cavity Assessment and Endometrial Hormonal Receptors in Women with Peri and Post- Menopausal Bleeding. IAIM, 2018; 5(7): 38-44. Page 39 positive results (3 cases was found to have polypi and 5 cases were normal). Mean endometrial thickness in mm in various diagnosis by TVUS as follows; endometrial polyp had 15.49±10.98, endometrial hyperplasia had 8.19±5.55, endometrial atrophy had 4.55±2.97 and normal endometrium had 12.68±6.80. Conclusion: Especially with intra-cavitary lesions, sonohysterography is superior to ultrasound and very close to hysteroscopy. Hysteroscopy remains the reliable standard for uterine cavity assessment, but cannot replace the histopathology. In the pathogenesis of endometrial polyps and endometrial hyperplasia, the expression of endometrial steroid receptors is crucial.
RESUMO
Objetivo: Demostrar que la revisión de la cavidad uterina instrumental gentil previene mayormente, la hemorragia posparto en comparación con la revisión manual de la cavidad uterina. Métodos: Estudio observacional, transversal, descriptivo y asociativo. Se llevó a cabo en las pacientes que ingresaron a las unidades toco-quirúrgicas de 2 hospitales públicos en el Estado de México. Muestreo por conveniencia (aquellas pacientes a quienes se les realizó revisión de cavidad uterina, durante la atención del parto). Muestra integrada por 236 pacientes. Resultados: Hubo 76 casos de hemorragia posparto, que se analizaron por grupos de edad, distinguiendo entre adolescentes, en edad reproductiva óptima y en edad materna avanzada, encontrándose mayor incidencia en el primer y tercer grupo, con el 34.4% y 48.3% de los casos, respectivamente. La relación entre hemorragia posparto y tipo de técnica de revisión de cavidad uterina, mostró mayor incidencia en la revisión manual. Los casos analizados según la instrucción del personal que brindó la atención, mostraron mayor número de casos de hemorragias, en quienes fueron atendidos por personal en formación. Los especialistas de Enfermería Perinatal, llevaron a cabo 97 procedimientos de atención de parto, 25 presentaron hemorragia posparto, frente a 72 que no presentaron la patología. Conclusiones: La revisión manual de cavidad uterina se asocia estrechamente con la aparición de hemorragia posparto, en contraste con la revisión instrumentada gentil, en la que se registró menor incidencia de esta complicación. La revisión de cavidad uterina debe practicarse bajo indicaciones precisas, hecho que contribuye a la disminución de complicaciones en el posparto.
Objective: to demonstrate that the gentle instrumental uterine cavity assessment largely prevents postpartum hemorrhage in comparison to the manual assessment. Methods: cross-sectional, observational, descriptive, and associative study on patients admitted to the labor-surgical units of two public hospitals in the State of México, using a convenience sample (patients to whom a uterine cavity assessment was performed during their labor process) of 236. Results: There were 76 total cases of post-partum hemorrhage. Patients were classified in three age groups: adolescents, optimal reproductive age, and advanced maternal age. Post-partum hemorrhage cases were prevalent in the first and third groups with 34.4% and 48.3% respectively. The manual uterine cavity assessment technique resulted in a higher prevalence of post-partum hemorrhage. More post-partum hemorrhage cases were also found in those patients attended by inexpert staff. Perinatal Nursing Specialists, conducted 97 childbirth care procedures, 25 had Postpartum Hemorrhage, compared to 72 who did not have the pathology. Conclusions: The manual uterine cavity assessment technique, is closely associated with the onset of Postpartum Hemorrhage, Gentle instrumented uterine cavity assessment resulted in a lower incidence of post-partum hemorrhage. In order to decrease post-partum complications, the uterine cavity assessment must be performed through precise procedures.