PREVALENCE OF BENIGN UTERINE PATHOLOGIES AND CORRELATION BETWEEN EPIDEMIOLOGICAL PROFILE AND ULTRASOUND FINDINGS IN WOMEN WITH ABNORMAL UTERINE BLEEDING IN A PUBLIC HOSPITAL IN THE FEDERAL DISTRICT
DOI:
https://doi.org/10.56238/arev8n1-100Keywords:
Adenomyosis, Leiomyomatosis, Ultrasound, Diagnostic Imaging, Uterine BleedingAbstract
Objectives: Given that abnormal uterine bleeding (AUB) is one of the most frequent gynecological complaints that motivate consultations for women of reproductive age, the scope of this study was based on estimating the prevalence of leiomyomas, endometrial polyps, and adenomyosis in women of reproductive age with abnormal uterine bleeding undergoing transvaginal ultrasound at a public hospital in the Federal District, correlating the epidemiological profile of the patients and the ultrasound findings. Methods: This is an observational, descriptive, and retrospective study. It was conducted at the Gynecology and Obstetrics Unit of the Taguatinga Regional Hospital, using data stored in electronic medical records via the TrakCare system, from patients seen in the Ultrasound Room between January 2022 and December 2024. The collected data were tabulated in Microsoft Excel Office 365 and organized into spreadsheets for descriptive analysis. The variables analyzed (age, parity, BMI, race, and associated comorbidities) were presented as absolute and relative frequencies, as well as means and percentages. The final sample composition for analysis was 233 patients, broken down as follows: endometrial polyps - 71 patients, uterine leiomyomatosis - 152 patients, and adenomyosis - 30 patients. Results: After careful analysis of the data, it can be concluded that these pathologies are common in women at the end of their reproductive years or the beginning of menopause, with all groups showing a very high prevalence of multiparity, a risk factor for polyps and adenomyosis. The association of these pathologies with hyperestrogenism was reinforced, since more than 70% of patients with polyps and adenomyosis had a high BMI. A high prevalence of black and brown patients was observed, similar across all three pathology groups. Among the patients analyzed, a large proportion had systemic arterial hypertension and diabetes mellitus, as well as breast cancer, raising the discussion about the use of tamoxifen and its endometrial proliferative effect. The most commonly described ultrasound findings associated with uterine leiomyomatosis were myometrial heterogeneity due to the presence of a solid, hypoechoic, well-defined, and regular image, either single or multiple. Adenomyosis was commonly described as areas of undifferentiation in the junctional zone, associated or not with the presence of myometrial cysts; another commonly described finding was asymmetry between the anterior and posterior uterine walls, with focal echogenicity alteration. Finally, endometrial polyps were described as frequently associated with endometrial thickening, with or without flow on Doppler study. Conclusion: The high prevalence of benign uterine pathologies in women of reproductive age is undeniable. This study reinforces the importance of these conditions, consolidating the clinical-epidemiological profile of affected patients. The imaging methods studied – transvaginal ultrasound (TVUS) – have highly suggestive findings for these pathologies and are undergoing constant improvement, solidifying TVUS as the preferred first diagnostic modality for the described pathologies.
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