No abstract

Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman’s normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women’s lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding.

Introduction. It is well known that many events during life can be stressful events, specifically events related to health. Abortion is an event that represents a robust risk factor for the development of anxiety symptoms. Induced abortions occur for many reasons, including genetic defect, missed abortion, various diseases of the mother, trauma etc. The impact of abortion (as stressful life events) in the etiology of anxiety disorders has been described in the literature. Anxiety disorders are defined as excessive worry or fear and tension about everyday events and problems or for any sudden stressful life events. Anxiety levels are typically classified into four categories: mild, moderate, severe and panic level anxiety. Objective. The primary objective of the study was to determine the anxiety scale before an induced abortion. Materials and methods. This is a cohort study. The study was conducted at the University Clinical Center of Kosovo, a tertiary care hospital. 189 women participated in the study waiting for abortions. The women were divided into two groups; 87 women designated for surgical abortion and 102 for drug-induced abortion. Both groups were assessed separately for presence and degree of anxiety. To evaluate these two parameters were used Hopkins Symptoms Checklist (HSCL-25). Only the first 10 HSCL-25 questions were used to assess the presence and anxiety scale. The anxiety scale was measured before the abortion. The primary outcome measures studied were the incidence of abortions, the average maternal age, type of induced abortion, presence of anxiety, and anxiety scale. Results. During the study period in our clinic, 1376 pregnant women were hospitalized, out of which 189 cases for abortion. The incidence rate of abortions was 13.7 per 1000 women aged 15-44 years. Of these 189 cases for abortion in both groups, 110 women or 58.2% had anxiety. The mean age of patients was 28.76 ± 6.2 years. Out of 110 cases that experienced anxiety during an induced abortion; 78.2% (86 cases) had mild anxiety, 19.1% (21 cases) moderate anxiety, and 2.7% (3 cases) severe anxiety. A comparison was made between the two groups, and it turned out those women with surgical abortions had a relative risk (RR) OF 1.5 times higher to experience anxiety during abortion procedures than not even women with drug-induced abortions. Anxiety was experienced by women in the form of phobias. Women who underwent surgical abortion mostly had phobias such as; phobia by uncontrollable bleeding (31.7%), followed by phobia by surgical abortion procedures (27%), phobia associated with anesthesia (14.3%), while women who underwent drug-induced abortion mostly had phobias by phobia associated with abortion failure, and likelihood for surgical abortion (44.7%), followed by phobia for developing infections (31.9%) etc. Conclusions. The results of this study show that the incidence of abortions was 13.7 per 1000 women aged 15-44 years. Regardless of the method of abortion, 58% of women experienced anxiety during the abortion procedure. Of these, 78% had low levels of anxiety, 19% moderate and 3% severe anxiety. Findings from our analysis show that women who had abortions with surgical abortions experienced 1.5 times more anxiety than women with drug-induced abortions.