Department of Obstetrics and Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
Department of Obstetrics and Gynaecology, Phuntsholing General Hospital, Chukha, Bhutan.
BMC Womens Health. 2024 Apr 2;24(1):214. doi: 10.1186/s12905-024-03047-6.
Women presenting with abnormal uterine bleeding needs careful and thorough assessment including ultrasound examination of endometrium and histopathological assessment of the endometrial tissues. The objective of this cross-sectional study was to determine the rate and the factors associated with inadequate endometrial tissues after endometrial sampling using MedGyn® pipette among Bhutanese women at the colposcopy clinic, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Bhutan.
This cross-sectional study was conducted at the colposcopy clinic, JDWNRH, Thimphu between October, 2021 and March, 2022. Women included in this study underwent endometrial sampling using MedGyn® pipette without anesthesia as an office procedure. Data were collected using an interviewer-administered questionnaire and results extracted into a structured pro forma. The histopathology reports were extracted from the Department of Pathology and Laboratory Medicine, JDWNRH using the unique Bhutanese citizenship identity card number of the study participants.
Inadequate endometrial tissues were noted in 27% (33 out of 122 cases). Among 89 patients with an adequate endometrial tissue, histologic results were normal in 30 (33.7%), benign pathology in 22 (24.7%), atrophy in 10 (8.2%), and hyperplasia in 27 (30.3%). In a univariate analysis, menopausal state (OR 1.6, 95% CI 0.708-3.765), overweight and obese (OR 1.6 95% CI 0.640-3.945), unemployed (OR 1.7, 95% CI 0.674-1.140), nulliparous (OR 1.7, 95% CI 0.183-15.816), primipara (OR 5.1, 95% CI 0.635-40.905) and use of hormonal contraception (OR 2.1, 95% CI 0.449-10.049) were associated with increased risk of inadequate endometrial tissues. On multivariate regression analysis, nulliparity (OR 1.1, 95% CI 0.101-12.061), overweight and obesity (OR 1.4, 95% CI 0.490-3.917), use of hormonal contraceptives (OR 2.2, 95% CI 0.347-13.889), and junior surgeons (OR 1.1, 95%CI 0.463-2.443) were found to be associated with inadequate endometrial tissues. However, the above associations were not statistically significant (p > 0.05).
The rate of inadequate endometrial tissue following endometrial sampling using MedGyn® pipette was 27.0%. Factors associated with an increased risk of inadequate endometrial tissue after endometrial sampling were menopausal state, overweight and obese, unemployed, nulliparous, primipara and use of hormonal contraception.
对于出现异常子宫出血的女性，需要仔细和全面的评估，包括子宫内膜超声检查和子宫内膜组织的组织病理学评估。本横断面研究的目的是确定在不使用麻醉的情况下使用 MedGyn®吸头进行子宫内膜取样后，不典型子宫内膜组织的发生率和相关因素。
本横断面研究于 2021 年 10 月至 2022 年 3 月在不丹的 Jigme Dorji Wangchuck 国家转诊医院（JDWNRH）的阴道镜检查门诊进行。纳入本研究的女性使用 MedGyn®吸头进行子宫内膜取样，作为一种门诊程序。使用访谈员管理的问卷收集数据，并将结果提取到一个结构化的表格中。使用研究参与者的不丹独特公民身份证号码从 JDWNRH 的病理学和实验室医学系提取组织病理学报告。
27%（122 例中有 33 例）的子宫内膜组织不足。在 89 例子宫内膜组织充足的患者中，组织学结果正常 30 例（33.7%），良性病变 22 例（24.7%），萎缩 10 例（8.2%），增生 27 例（30.3%）。在单因素分析中，绝经状态（OR 1.6，95%CI 0.708-3.765）、超重和肥胖（OR 1.6，95%CI 0.640-3.945）、失业（OR 1.7，95%CI 0.674-1.140）、未产妇（OR 1.7，95%CI 0.183-15.816）、初产妇（OR 5.1，95%CI 0.635-40.905）和使用激素避孕（OR 2.1，95%CI 0.449-10.049）与子宫内膜组织不足的风险增加相关。多因素回归分析显示，未产妇（OR 1.1，95%CI 0.101-12.061）、超重和肥胖（OR 1.4，95%CI 0.490-3.917）、使用激素避孕药（OR 2.2，95%CI 0.347-13.889）和初级外科医生（OR 1.1，95%CI 0.463-2.443）与子宫内膜组织不足相关。然而，这些关联没有统计学意义（p>0.05）。
使用 MedGyn®吸头进行子宫内膜取样后，子宫内膜组织不足的发生率为 27.0%。与子宫内膜取样后子宫内膜组织不足风险增加相关的因素包括绝经状态、超重和肥胖、失业、未产妇、初产妇和使用激素避孕。
