E.A. SANDAKOVA¹, I.G. ZHUKOVSKAYA²

¹E.A. Vagner Perm State University of the Ministry of Health of the Russian Federation, Perm

²Izhevsk State Medical Academy of the Ministry of Health of the Russian Federation, Izhevsk

  Contact details:

Zhukovskaya I.G. – MD, Associate Professor of the Department of Obstetrics and Gynecology

Address: 281 Kommunarov Str., 426034, Izhevsk, Udmurt Republic, e-mail: zhoukovskaya@mail.ru

Research objective: to study the state of health results of clinical-morphologic examination in women during menopausal period (43-55 y.o.), diagnosed with abnormal uterine bleeding (AUB) and requiring surgical haemostasis.

Material and methods. The control group I included 50 female patients with AUB who had indications for endometrial biopsy within hysteroscopic procedure; the comparison group II consisted of 30 female patients of the same age having normal menstrual cycle. The research methods included questioning (HELP assessment of menstrual blood loss), standard clinic check-ups and pelvic examinations, cervical secretion bacterioscopy, general blood test and urine analysis, pelvic ultrasound scanning, morphological study of endometrium biopsy samples, and consultation of a physician.

Results. AUB is obviously co-morbid with obesity (32.0±6.5% and 6.7±4.6%; p<0.01) and hypertension (52.0±6.9% and 13.3±3.1%; p<0.001) that indicates a huge contribution of metabolic disorders into the development of the condition discussed. Individual peculiarities in women’s reproductive behavior are risk factors of AUB, such as early start of sex life (50.0±7.1% and 16.6±6.8%; p<0.001), surgical abortions, active use of inert intrauterine contraceptives (48.0±7.1% and 20.0±7.3%; p<0.05), and smoking (32.0±6.6% and 13.6±6.1%; p<0.05). The main causes of AUB are ovulatory and endometrial dysfunctions (30.0%) and uterine structural changes (70.0%).

Conclusion. The problem of AUB demands interdisciplinary approach and close collaboration of obstetricians-gynaecologists, ultrasound diagnostic specialists, morphologists, physicians, and endocrinologists. It will contribute to the proper identification of AUB cause factors and development of individualized medical and preventive treatment courses.

Key words: abnormal uterine bleeding, menopausal period.

  (For citation: Sandakova E.A., Zhukovskaya I.G. Clinical-morphological aspects of abnormal uterine bleeding in menopausal period. Practical medicine. 2019. Vol. 17, № 4, P. 72-76)

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