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Uterine Bleeding (uterine + bleeding)
Kinds of Uterine Bleeding Selected AbstractsAngiogenesis in the female reproductive organs: pathological implicationsINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 4 2002Lawrence P. Reynolds Summary. The female reproductive organs (ovary, uterus, and placenta) are some of the few adult tissues that exhibit regular intervals of rapid growth. They also are highly vascular and have high rates of blood flow. Angiogenesis, or vascular growth, is therefore an important component of the growth and function of these tissues. As with many other tissues, vascular endothelial growth factors (VEGFs) and fibroblast growth factors (FGFs) appear to be major angiogenic factors in the female reproductive organs. A variety of pathologies of the female reproductive organs are associated with disturbances of the angiogenic process, including dysfunctional uterine bleeding, endometrial hyperplasia and carcinoma, endometriosis, failed implantation and subnormal foetal growth, myometrial fibroids (uterine leiomyomas) and adenomyosis, ovarian hyperstimulation syndrome, ovarian carcinoma, and polycystic ovary syndrome. These pathologies are also associated with altered expression of VEGFs and/or FGFs. In the near future, angiogenic or antiangiogenic compounds may prove to be effective therapeutic agents for treating these pathologies. In addition, monitoring of angiogenesis or angiogenic factor expression may provide a means of assessing the efficacy of these therapies. [source] Sonohysterography is superior to transvaginal sonography for the diagnostic approach of irregular uterine bleeding in women of reproductive ageJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2006Dimitrios Botsis MD Abstract Purpose. To evaluate and compare the accuracy of transvaginal sonography (TVS) and sonohysterography (SHG) in the investigation of women of reproductive age presenting with irregular uterine bleeding (IUB). Methods. This prospective study included 104 women presenting with IUB. All patients underwent TVS, SHG, and hysteroscopy, during which endometrial biopsies were obtained and any endometrial mass was treated with hysteroscopic surgery. Statistical analysis was performed by calculating the sensitivity, specificity, and positive and negative predictive values of TVS and SHG in diagnosing endometrial polyp, submucous myoma and all endometrial pathologies (polyp, submucous myoma, endometrial hyperplasia, and endometrial carcinoma) with the histopathological report of the tissues obtained by hysteroscopy serving as the end point for the analysis. Results. The sensitivity, specificity, and positive and negative predictive values, respectively of TVS were 61.2%, 90.9%, 85.7%, and 72.5% for diagnosing endometrial polyps; 75.0%, 92.0%, 63.1%, and 95.3% for diagnosing submucous myomas; and 75.0%, 80.6%, 87.9%, and 63.0% for diagnosing any kind of pathology. The corresponding diagnostic values of SHG were 83.7%, 96.4%, 95.3%, and 86.9% for polyps; 87.5%, 98.9%, 93.3%, and 97.8% for submucous myomas; and 88.2%, 91.7%, 95.2%, and 80.5% for any kind of pathology. Conclusions. SHG showed superior sensitivity, specificity, and positive and negative predictive values compared with TVS in diagnosing intrauterine lesions in women of reproductive age with IUB. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2006 [source] Late solitary metastasis of cutaneous malignant melanoma presenting as abnormal uterine bleedingJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4pt2 2008Massimiliano Fambrini Abstract We present the case of a 52-year-old woman with a history of excised cutaneous malignant melanoma complaining of abnormal uterine bleeding 11 years after initial diagnosis. Hysteroscopic examination showed an endometrial lesion with polypoid shape and endometrial biopsy was suggestive for melanoma. After a complete clinical work-up ruling out other metastatic sites, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Final histopathological and immunohistochemical analysis confirmed the diagnosis of endometrial melanoma with initial myometrial invasion. After a 6-month follow-up period, the patient was disease free. Even after many years of negative follow up, gynecologists should be aware of the possibility that abnormal uterine bleeding could represent the clinical expression of metastatic melanoma in order to offer a prompt diagnosis and a personalized strategy of treatment. [source] Hamartomatous endocervical polyp with heterologous mesenchymal tissuePATHOLOGY INTERNATIONAL, Issue 4 2001dvan Ilhan We present an endocervical polyp with heterologous elements. Although a few neoplastic cervical lesions with cartilaginous and adipocytic heterologous tissue have been reported, an endocervical polyp with heterologous cartilage and adipose tissue has not been reported before our case. The patient was a 33-year-old woman who presented with abnormal uterine bleeding. On physical examination, there were no remarkable findings other than a cervical polyp protruding into the cervical canal. The polyp was removed. Pathological examination revealed an endocervical polyp with typical epithelial features. The stroma of the polyp contained mature cartilage islands and adipose tissue. There were also many thick-walled vascular structures. Neither stromal periglandular condensation nor atypia was found. Mitotic figures were not observed. Arteriolar structures did not contain internal elastic lamina. In our opinion, these pathological findings are all consistent with a hamartomatous lesion rather than with a true neoplasm. [source] Intra-uterine bupivacaine and levobupivacaineAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010Ayse MIZRAK Aim:, The study aimed to compare the effect of intrauterine bupivacaine and levobupivacaine with placebo in reducing the post-procedure discomfort owing to pain caused by suction endometrial sampling. Methods:, This study was conducted on randomly selected 45 women with abnormal uterine bleeding and who had undergone outpatient hysteroscopy and endometrial biopsy under sedation with propofol 0.5 mg/kg. The study was performed using 5 mL of bupivacaine 0.5% (Group B, n = 15) or levobupivacaine 0.5% (Group L, n = 15) or placebo solution (Group C, n = 15) intrauterine via a catheter over a 5 min period after suction endometrial sampling. The number of patients with visual analogue scale >3, total postoperative analgesic requirements, satisfaction of patients and adverse events were measured. Nonparametric and parametric data were analysed using Kruskal,Wallis and one-way anova tests respectively. Results:, Women in Groups L and B had statistically significantly less pain than the women in Group C (P = 0.03). When compared with placebo, five ml of bupivacaine 0.5% and levobupivacaine 0.5% respectively were recorded to decrease the incidence of postoperative analgesic consumption from 41 to 35% (P = 0.01). The satisfaction score of the patients in Group L was significantly higher than that of the patients in Group C (P = 0.03). Conclusion:, Intrauterine levobupivacaine or bupivacaine is effective in decreasing the pain associated with the endometrial biopsy and curettage under propofol sedation. [source] Outpatient hysteroscopy: Factors influencing post-procedure acceptability in patients attending a tertiary referral centreAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009Kate MCILWAINE Background:, Ambulatory hysteroscopy is a safe, reliable and cost-effective alternative to hysteroscopy under a general anaesthetic for the diagnosis of abnormal uterine bleeding. Aim:, The objective of this study was to assess which factors influenced patients' willingness to attend for future outpatient hysteroscopy. The outpatient hysteroscopy service commenced at the Mercy Hospital for Women in 2000. It provides women with the opportunity to have the cause of abnormal uterine bleeding diagnosed in an outpatient setting. Methods:, A prospective audit was conducted of 283 women attending for outpatient hysteroscopy at the Mercy Hospital for Women over a period of almost five years (May 2003 through February 2008). Results:, Of the women audited, 88.7% stated that they would accept the procedure in future, whilst 11.3% would not. There was a significant difference between the two groups with respect to their median visual analogue pain scale (VAS) pain scores during the procedure (3.00 versus 6.50 P < 0.0001) with the higher score in the group who would not re-attend for the procedure. There was also a significant difference between the two groups with respect to the change in median VAS score from pain anticipated to pain experienced (0.00 versus 3.50 P = 0.0001). The rate of unsuccessful procedures was significantly higher (40.6% versus 0.8%P < 0.05) in future non-attendees as well as a higher rate of clinical vasovagal episodes (25% versus 5.2%P = 0.01) in women who stated that they would not re-attend for the procedure. Preprocedure analgesia and type of anaesthetic administered during the procedure did not seem to influence whether women would attend for outpatient hysteroscopy in future. Conclusions:, The acceptability rate for women attending for outpatient hysteroscopy during the audit period was 88.7%. Pain was a significant determinant of procedure acceptability; however, the acceptability rate was not influenced by analgesia or type of anaesthetic administered. [source] Efficacy of micronised vaginal progesterone versus oral dydrogestrone in the treatment of irregular dysfunctional uterine bleeding: A pilot randomised controlled trialAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009Savas KARAKUS Background:, The vaginal route is more effective than the other drug delivery routes for some specific indications. Aim:, To compare the efficacy of a vaginal progesterone preparation with that of oral dydrogesterone. Methods:, A total of 69 women with irregular dysfunctional uterine bleeding were randomly assigned into one of two groups: oral dydrogesterone group (n = 35) and vaginal progesterone group (n = 34). At the end of a three-month treatment period, the women were re-evaluated. The endometrial histology findings and menstrual cycle characteristics were used as primary outcome measures. Pearson chi-square and Fisher's exact test were used for data analysis. Results:, Findings from 54 eligible women were evaluated. There was no statistically significant difference in both menstrual recordings and endometrial histology results between the groups. Conclusions:, Vaginal micronised progesterone could be an alternative to oral preparations in the treatment of dysfunctional uterine bleeding. This needs to be further evaluated in adequately controlled randomised trials against other effective treatments. [source] Bleeding disorders in teenagers presenting with menorrhagiaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2005Yasmin JAYASINGHE Abstract Objective:, To assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women. Design:, A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia. Setting:, Inpatient and outpatients of a tertiary adolescent gynaecology service. Patients:, Subjects aged 9,19 years with menorrhagia who had coagulation tests performed, and who did not have a known bleeding disorder prior to presentation were included. Outcome measures:, A bleeding screen was performed to assess prevalence of bleeding disorders in the population. Variables that were investigated as predictive of a bleeding disorder included clinical history, family history, and haematological indices of blood loss. Results:, The prevalence of an inherited bleeding disorder was 10.4%. The only statistically significant predictor was a family history of bruising and bleeding. Menstrual history was not predictive. Conclusion:, Severity of menstrual loss was not predictive of a bleeding disorder, as a significant cause of teenage metrostaxis is due to anovulatory dysfunctional uterine bleeding. The authors recommend that a careful personal and family history of bruising and bleeding be taken in all teenagers who present de novo with menorrhagia. Routine screening in a primary care setting is impractical, but should be mandatory in all patients with a positive family history. [source] Women's experiences of student presence in consultations for problematic uterine bleedingBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2004Jennifer Guise Research suggests that although a high proportion of patients accept the presence of students in gynaecological consultations, issues of consent, privacy and comfort are important. This study considers women's views on the impact of student presence on communication in the consultation. Our research suggests that student presence may distort the flow of communication in the gynaecological consultation. There are implications for both patient satisfaction and clinician training. If students are introduced into the consultation, clinical tutors should take special care to maintain dedicated communication with the patient. [source] A double-blind randomised trial of leuprorelin acetate prior to hysterectomy for dysfunctional uterine bleedingBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2000D. J. R. Hutchon No abstract is available for this article. [source] | ||||||||||