Shagufta Shaheen, Shahnaz Akhtar, Naeema Utman.
Causes of Menorrhagia and its pathological diagnosis by dilatation and curettage.
J Postgrad Med Inst Jan ;19(1):62-6.

Objective: To find out the causes of menorrhagia and role of diagnostic dilatation and curettage. Material and Methods: This prospective study was conducted in department of Obstetric and Gynecology Lady Reading Hospital Peshawar from 1st January 1997 to December 1997. One hundred and twenty one patients with menorrhagia were studied. The age range was between 21-40 years. Full investigations for the causes of menorrhagia were carried out. All the patients having menstrual blood loss of more than 8 days or history of passage of clots or having hemoglobin less than 10 gm/dI were included in the study and patients having pubertal menorrhagia less than 20 years were excluded. Results: Out of 121 cases, 72 patient (59.5%) had menorrhagia above the age of 40 years. Fibroid uterus was the commonest cause found in 57 (47.10%) cases, Adenomyosis was the second common cause of menorrhagia found in 40 cases (33.05%), endometrial hyperplasia in 6 cases (4.95%). All of them were anemic. Severe anemia was found in 7 cases. Diagnostic D and C was done in all cases. 70 (58.67%) patients had proliferative endometrium. Only one patient had carcinoma endometrium. No Mortality was seen. Conclusion: All patients having menorrhagia during reproductive age and above 40 years should be screened for any endometrial pathology. Accurate analysis of endometrial sampling is the key to effective therapy and optimal outcome.

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