Open AccessObjectives : To study the causes of abnormal uterine bleeding in perimenopausal women and to correlate their clinical evaluation with ultrasonographic and histopathological examination.
Method : This is a retrospective study of 100 perimenopausal women with complaint of abnormal bleeding in the age group ranging from 40 years till 1 year within the menopause, who underwent hysterectomy at Lok Nayak Hospital. The age, parity, menstrual complaints of these patients were noted & clinical diagnosis and ultrasonography were analysed. Finally, histopathology report of the hysterectomy specimen was correlated with the clinical profile of the patient and ultrasonographic findings.
Results : Maximum frequency of abnormal uterine bleeding was seen in the age group 40– 45 years. Most of the patients were para 3. Menorrhagia was the commonest complaint & fibroid uterus was responsible for abnormal uterine bleeding in 53% of women. Out of 42 women labelled clinically as dysfunctional uterine bleeding, 9 patients were diagnosed with fibroid uterus on ultrasound, 3 with malignancy, 1 with adenomyosis & in rest of the 30 patients, no organic cause was found. Out of these 30 patients, 6 patients were diagnosed to have adenomyosis on histopathology & in rest 24 patients, no gross pathology was detected. Suspected malignancy in all the 3 patients was confirmed on histopathology. Simple endometrial hyperplasia without atypia was present in 24% patients.
Conclusion : Clinical, radiological & pathological evaluation correlated well to diagnose fibroids, however clinically as well as ultrasound proved to be of little help in diagnosing adenomyosis.