Prevalence and patterns of post menopausal bleeding at the nnamdi azikiwe university teaching hospital nnewi nigeria - a 5 .pdf

Abstract

BACKGROUND
OBJECTIVES
To determine the prevalence and
patterns of postmenopausal bleeding.
Materials and methods:
This was a retrospective study
conducted on all the cases of
postmenopausal bleeding managed at
Nnamdi Azikiwe University Teaching
Hospital Nnewi between 1st January
2014 and 31st December 2018. Data
was obtained from the case notes
retrieved from the medical records
department and from gynecological
ward and clinic registers. The
information obtained included age,
parity, year since menopause, history of
hypertension and diabetes mellitus,
time of onset of postmenopausal
bleeding, duration of bleeding, bleeding
frequency, and subjective measurement
of bleeding and histological diagnosis.
Data analysis was done using SPSS
version 21.
Results:
Out of the 1640 gynaecological
admissions, 53 were for
postmenopausal bleeding, giving a
prevalence of 3.2% for postmenopausal
bleeding. A total of 46 out of the 53
case files were retrieved from medical,
and were used for further analysis.
Twenty-two (47.8%) were found in
women between the ages of 55 to
65years. The majority of the cases
58.7% were found amongst the
grandmultipara. Majority (82.6%) of the
documented cases, were found in
women who have been menopausal for
at least 12 months and only one case
was reported in women menopausal for
less than 12 months. History of
hypertension and diabetes mellitus were
found in 11 (23.9%) and 7 (15.2%) of the
women respectively. PMB was first
noticed at least 6 months
postmenopausal in 24 (52.3%).
Recurrent PMB was experienced by 38
(82.6 %) of the women in the study
while 3 (6.5%) presented with a single
episode. Subjective estimation of
bleeding revealed that 20 (43.5%) of the
patients used in the study had either
slight or heavy bleeding. Histological
diagnosis showed that squamous cell
carcinoma of the cervix and other
histological types of cervical
malignancies accounted for 12 (26.1%)
and 7 (15.2%) of all histological
diagnoses, respectively.
Conclusion:
In conclusion, PMB is a common
gynecological presentation in our
environment. It is closely associated
with diabetes mellitus and hypertension
with the leading cause in our climes
being cervical malignancy which is
largely preventable. Therefore, health
policies should be targeted towards
medical education, lifestyle