Flayah, M., Hussein, A. (2024). Clinicopathological Assessment of Postmenopausal Bleeding in a Sample of Iraqi Patients. , 23(1), 73-80. doi: 10.52573/ipmj.2024.183106
Maha Jabber Flayah; Alaa Ghani Hussein. "Clinicopathological Assessment of Postmenopausal Bleeding in a Sample of Iraqi Patients". , 23, 1, 2024, 73-80. doi: 10.52573/ipmj.2024.183106
Flayah, M., Hussein, A. (2024). 'Clinicopathological Assessment of Postmenopausal Bleeding in a Sample of Iraqi Patients', , 23(1), pp. 73-80. doi: 10.52573/ipmj.2024.183106
Flayah, M., Hussein, A. Clinicopathological Assessment of Postmenopausal Bleeding in a Sample of Iraqi Patients. , 2024; 23(1): 73-80. doi: 10.52573/ipmj.2024.183106

Clinicopathological Assessment of Postmenopausal Bleeding in a Sample of Iraqi Patients

Iraqi Postgraduate Medical Journal
Article 12, Volume 23, Issue 1, January 2024, Pages 73-80    PDF (373.28 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2024.183106
Authors
Maha Jabber Flayah* 1; Alaa Ghani Hussein2
1Department of Pathology, Al-Imamain Al-Kadhmain City, Baghdad, Iraq.
2The Iraqi Board for Medical Specializations, Baghdad- Iraq.
Abstract
ABSTRACT:
BACKGROUND:
Bleeding that occurs 12 months or more following the last menstrual period is known as postmenopausal bleeding.
OBJECTIVE:
Is to assess the frequency and pattern of uterine lesions in women with post-menopausal bleeding and to correlate the histopathological changes with clinical variable i.e. the age, associated illness, parity and ultrasonography finding.
MATERIALS AND METHODS:
A retrospective study, which include analysis of 110 cases of women presented with post-menopausal bleeding, the samples were collected from the Teaching Laboratories of Al-Imamain Al-Kadhumain, and Baghdad Medical City from January 2020 to June 2021. For each case  the histopathological reports, slides  and  Paraffin block (if needed)  were collected, in addition the clinical parameters such as age, parity, history of previous Dilatation &Curettage, diabetes mellitus and/or hypertension, and ultrasound findings such as (endometrial thickness, uterine size) were also obtained.
RESULTS:
The age range of 110 cases was (45-90 years) with a mean age of 58 years ± 6.6 years. Hypertension was the most common associated illness as it was present in (42.7%) cases. Diabetes mellitus was present in (33.6%) patients. The parity distribution was (4.5%) cases recognized as nulliparous, and (95.4%) were multiparous. The endometrial thickness obtained from ultrasonography ranged from (3-25) mm and distributed as following: 22 (20%) cases were equal to or less than 4 mm, and (80%) were more than 4mm.The most common histopathological diagnosis was endometrial hyperplasia with frequency of (28.5%) of cases and (10.9%) cases were diagnosed as carcinoma.
CONCLUSION:
The most common etiology for postmenopausal bleeding was endometrial hyperplasia. While, the lowest one was chronic endometritis. There is significant correlation between the clinical parameters with endometrial hyperplasia and malignancy.
 
Keywords
postmenopausal bleeding; retrospective, endometrial carcinoma; endometrial hyperplasia, histopathology
References
  1. Hsu, C. Y., Chen, C. P., & Wang, K. L.. Assessment of postmenopausal bleeding. International Journal of Gerontology, 2008;2: 55-59.
  2. Mirkin, S., Archer, D. F., Taylor, H. S., Pickar, J. H., & Komm, B. S.. Differential effects of menopausal therapies on the endometrium. Menopause, 2014;21: 899-908.
  3. Goodman, A.. Abnormal genital tract bleeding. Clinical cornerstone, 2000;3: 25-35.
  4. Nicholson, W. K., Ellison, S. A., Grason, H., & Powe, N. R.. Patterns of ambulatory care use for gynecologic conditions: a national study. American journal of obstetrics and gynecology, 2001;184: 523-30.
  5. Alshdaifat, E. H., El-Deen Al-Horani, S. S., Al-Sous, M. M., Al-Horani, S., Sahawneh, F. E., & Sindiani, A. M. Histopathological pattern of endometrial biopsies in patients with abnormal uterine bleeding in a tertiary referral hospital in Jordan. Annals of Saudi Medicine, 2022;42: 204-13.
  6. Park, Y. R., Lee, S. W., Kim, Y., Bae, I. Y., Kim, H. K., Choe, J., & Kim, Y. M. Endometrial thickness cut-off value by transvaginal ultrasonography for screening of endometrial pathology in premenopausal and postmenopausal women. Obstetrics & gynecology science, 2019; 62:445-53.
  7. Raglan, O., Kalliala, I., Markozannes, G., Cividini, S., Gunter, M. J., Nautiyal, J., Gabra H., Paraskevaidis E., Martin-Hirsch P., Tsilidis Kostas K., Kyrgiou M., & Kyrgiou, M. Risk factors for endometrial cancer: an umbrella review of the literature. International journal of cancer, 2019; 145: 1719-30.
  8. Goetzl, L. M.. ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin. Clinical Management Guideline for Obstetrician-Gynecologists Number 36, July 2002. Obstetric analgesia and anesthesia. Obstet Gynecol.2002;100: 177-91.
  9. Al-Turiahi¹, A. M., El-Dine, F. A., & Herez, S. H. Assessment of postmenopausal bleeding: a cohort case study. American Journal of Bio. Medicine AJBM, 2016;4: 263-80.
  10. Annekathryn G. Approach to the patient with postmenopausal uterine bleeding. Available from: https://www.uptodate.com/contents/approach-to-the-patient-with-postmenopausal-uterine-bleeding?search=patient-information-vaginalhysterectomy&topicRef=8414&source=see_link. Accessed on 7/2021
  11. Morice, P., Leary, A., Creutzberg, C., Abu-Rustum, N., & Darai, E. Endometrial cancer. The Lancet, 2016;387: 1094-1100.
  12. Singh V, Nath S, Mohanta C. Clinicopathological Study of Postmenopausal Bleeding. International Journal of Advanced Research.2017;5:408-21.
  13. Kothapally, K., & Bhashyakarla, U. Postmenopausal bleeding: clinicopathologic study in a teaching hospital of Andhra Pradesh. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013;2: 344-49.
  14. Shatha Zakar S. Clinicopathological assessment of endometrial changes in patients with postmenopausal bleeding. Babylon University Journal. 2005;10.
  15. Al-Neaimy, W. M. T., Ahmed, M. T., & Al-Jawadi, S. I. Histopathological Interpretation of Abnormal uterine bleeding after the age of 40 year. Iraqi Postgrad Med J, 2010;9: 274-82.
  16. Jillani, K., Khero, R. B., Maqsood, S., & Siddiqui, M. A. Prevalence of malignant disorders in 50 cases of postmenopausal bleeding. JPMA. The Journal of the Pakistan Medical Association, 2010;60:540.
  17. Bani-Irshaid, I., & Al-Sumadi, A. Histological findings in women with postmenopausal bleeding: Jordanian figures. EMHJ, 1995;17.
  18. Shushan, A., Revel, A., & Rojansky, N.. How often are endometrial polyps malignant?. Gynecologic and obstetric investigation, 2004;58: 212-15.
  19. Ben-Arie, A., Goldchmit, C., Laviv, Y., Levy, R., Caspi, B., Huszar, M., Dagni R., & Hagay, Z.. The malignant potential of endometrial polyps. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2004;115: 206-10.
  20. Clark, T. J., & Stevenson, H. Endometrial Polyps and Abnormal Uterine Bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated?. Best practice & research Clinical obstetrics & gynaecology, 2017;40: 89-104.
  21. Antunes Jr, A., Costa-Paiva, L., Arthuso, M., Costa, J. V., & Pinto-Neto, A. M.. Endometrial polyps in pre-and postmenopausal women: factors associated with malignancy. Maturitas, 2007; 57: 415-21.
 

Statistics
Article View: 292
PDF Download: 130


Journal Management System. Powered by iJournalPro.com