A Study on Relationship of Endometrial Thickness and Abnormal Uterine Bleeding in Perimenopausal Women

JOURNAL TITLE: Journal of SAFOMS

Author
1. Anand Jaiswal
2. Jyoti Jaiswal
ISSN
2319-846X
DOI
10.5005/jp-journals-10032-1150
Volume
6
Issue
2
Publishing Year
2018
Pages
6
Author Affiliations
    1. Department of Obstetrics and Gynaecology, Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India
    1. Department of Radiodiagnosis, Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India
  • Article keywords
    AUB, Endometrial thickness, Perimenopause

    Abstract

    Aims and objectives: To study the possible relationship between abnormal uterine bleeding (AUB) and endometrial thickness in perimenopausal women. Materials and methods: A prospective observational study conducted on 60 cases of AUB in perimenopausal age (41–55 years) group. Results: Institutional incidence of AUB in general and AUB in perimenopausal age was 10.7% and 29.38% respectively. Maximum cases were para 3 and of age 41–45 years (78.33%). Cases presented with irregular and heavy menstrual bleeding (76.66%). About one-third (33.33%) of the study subjects were suffering from severe and life-threatening anemia due to AUB. 90% study subjects required a blood transfusion, maximum of them were transfused preoperatively. As per PALM-COEIN classification, maximum cases had leiomyoma (41.66%) as a structural cause of AUB followed by malignancy and hyperplasia (33.33%). Majority of cases (45%) presenting with AUB had an endometrial thickness between 6–9 mm. Mean endometrial thickness was maximum in cases of AUB M that is 10.33 mm followed by AUB-L 7.56 mm, and AUB-A 7.2 mm. Majority of cases (70%) with ET 9 mm or less were having mild to moderate blood loss. Majority of cases with severe blood loss higher endometrial thickness; half subjects had ET >10 mm, and few had ET 16 to 21 mm. Cafeteria approach for choosing the management line was given. Most of the perimenopausal cases preferred the surgical line of management (83.33%) over medical method (13.33%) despite counseling. Conclusion: Endometrial thickness of more than 7 mm remains a common feature with estrogen-dependent conditions like fibroid, adenomyosis, hyperplasia, and malignancy even during perimenopause. Clinical Significance: AUB in perimenopause needs vigilant surveillance, and endometrial thickness may be a relevant tool for it.

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