Kavitha, J (2013) Epidemiological study of non structural causes abnormal uterine bleeding. Masters thesis, K.A.P. Viswanatham Government Medical College, Tiruchirappalli.
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Abstract
INTRODUCTION: The most common presenting complaint encountered in the Gynecological practice, its incidence accounting as much as 30-40%. The availability of diagnostic tools such as ultrasound, clinical endometrial sampling and diagnostic hysteroscopy has made it possible to promptly diagnose and treat an increasing number of menstrual disorders is an office setting. Menstruation is a cyclical phenomenon that routinely begins at menarche and ends at menopause. The normal menstrual rhythm is regulated and modulated by the hormones secreted by hypothalamus, pituitary and ovaries. AIM OF THE STUDY: 1. To conduct in depth analysis of non structural causes of abnormal uterine bleeding. 2. To find the incidence of non structural causes of AUB with special emphasis on careful history taking and clinical examination and inclusion of simple test to diagnose hemostatic disorders. 3. To find out relations between age and symptoms. 4. To find out the morbidity parameters of non structural causes of AUB. MATERIALS AND METHODS This is a prospective study conducted in Mahatma Gandhi Memorial Hospital, Trichy during period of June 2011-May 2012. Inclusion Criteria: • Age between 13-55 yrs. • With clinical sign and symptoms of AUB. Exclusion Criteria: • Ultra sonically diagnosed structural causes of AUB from the patients with age of 13-55 yrs METHODS: 1. History. 2. Clinical assessment. 3. Complete blood count. 4. Hb% by sahli hemoglobinometer normal value is 11-14gms%. 5. Packed cell volume -28-32% 6. TC DC P L E. 7. RBC VALUE IN – 5-6 millions/cumm. 8. PERIPHERAL SMEAR – leishman stain and geimsa stain by oil immersion method [for 10 hpf]. 9. RBC VALUE IN – 5-6 millions /cu mm. 10. Thyroid function test – TSH-.44-.345 MIU /ML T-3 LEVELS-.49-2.02NG/ML T-4 VALUE MICRO GRAM/DL. 11. LIVER FUNCTION TESTS – as per lab values. 12. BLEEDING TIME blotting paper method -2-3 min. 13. Clotting time –tube method 3-5 min. 14. PROTHROMBIN TIME & ACTIVATED PARTIAL PROTHROMBIN. TIME by siemens thromborel kit. 17. FACTOR 8 AND 9 LEVELS AS PER KIT. 18. SPUTUM FOR ACID FAST BACILLUS by ziehl nielson technique. 19. X-ray chest PA view. 20. USG TO R/O Structural Causes. 21. ENDOMETRIAL BIOPSY by pipelles endometrial currete in indicated cases. 22. Endometrial culture in possible cases in lowenstein Jensen medium specimen concentrated by modified petroff method. SUMMARY: 1. During the one year study May 2011 to June 2012 of 2318 patients of which an average of 39.33 % had AUB. 2. Overall incidence of detectable non-structural causes in our hospital is 52.5 %. 3. Definite increase in incidence of abnormal uterine bleeding in both extremes of age. 4. Incidence of identifiable coagulation abnormalities is 12.5 %. 5. Incidence of endometrial causes is 10 %. 6. Incidence of detectable ovulation dysfunction is 30 %. There is a definite association of menstrual irregularities with the thyroid dysfunction irrespective of age factor. CONCLUSION: Considering the abnormal menstrual bleeding which is the most common complaint that the reproductive age group women bring to the physicians, all clinicians who provide the primary care for the women must have an organized logical approach to the evaluation and treatment of the problem. Careful history taking algorithmic approach of investigations rules out non-structural causes. In a considerable amount of patients and avoids unnecessary hysterectomy. Evaluation of patients with the abnormal uterine bleeding is an art of the clinician in getting the diagnosis with simple reliable tests.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | non structural causes ; abnormal uterine bleeding ; Epidemiological study. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Punitha K |
| Date Deposited: | 17 Jun 2018 09:40 |
| Last Modified: | 27 Mar 2020 02:15 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8541 |
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