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

BACKGROUNDOBJECTIVESTo determine the prevalence andpatterns of postmenopausal bleeding.Materials and methods:This was a retrospective studyconducted on all the cases ofpostmenopausal bleeding managed atNnamdi Azikiwe University TeachingHospital Nnewi between 1st January2014 and 31st December 2018. Datawas obtained from the case notesretrieved from the medical recordsdepartment and from gynecologicalward and clinic registers. Theinformation obtained included age,parity, year since menopause, history ofhypertension and diabetes mellitus,time of onset of postmenopausalbleeding, duration of bleeding, bleedingfrequency, and subjective measurementof bleeding and histological diagnosis.Data analysis was done using SPSSversion 21.Results:Out of the 1640 gynaecologicaladmissions, 53 were forpostmenopausal bleeding, giving aprevalence of 3.2% for postmenopausalbleeding. A total of 46 out of the 53case files were retrieved from medical,and were used for further analysis.Twenty-two (47.8%) were found inwomen between the ages of 55 to65years. The majority of the cases58.7% were found amongst thegrandmultipara. Majority (82.6%) of thedocumented cases, were found inwomen who have been menopausal forat least 12 months and only one casewas reported in women menopausal forless than 12 months. History ofhypertension and diabetes mellitus werefound in 11 (23.9%) and 7 (15.2%) of thewomen respectively. PMB was firstnoticed at least 6 monthspostmenopausal in 24 (52.3%).Recurrent PMB was experienced by 38(82.6 %) of the women in the studywhile 3 (6.5%) presented with a singleepisode. Subjective estimation ofbleeding revealed that 20 (43.5%) of thepatients used in the study had eitherslight or heavy bleeding. Histologicaldiagnosis showed that squamous cellcarcinoma of the cervix and otherhistological types of cervicalmalignancies accounted for 12 (26.1%)and 7 (15.2%) of all histologicaldiagnoses, respectively.Conclusion:In conclusion, PMB is a commongynecological presentation in ourenvironment. It is closely associatedwith diabetes mellitus and hypertensionwith the leading cause in our climesbeing cervical malignancy which islargely preventable. Therefore, healthpolicies should be targeted towardsmedical education, lifestyl