Published: 2021-03-24

Study of histopathological patterns of endometrium in abnormal uterine bleeding

Anitha S., Pooja G., Sowmya D.


Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology out- patient department. Endometrial sampling could be effectively used as the first diagnostic step in AUB. This study was done to evaluate histopathology of endometrium for identifying the endometrial causes of AUB. And also, to observe the incidence of various endometrial pathology in different age groups presenting with abnormal uterine bleeding.

Methods: A one-year prospective study conducted in the department of obstetrics and gynaecologist in A. J. institute of medical sciences and research centre which included 200 cases of clinically diagnosed AUB patients. Histopathological examination of endometrial biopsies specimens was done, followed by clinical correlation.

Results: The most common age group presenting with AUB was 41-50 years (43.84%). The commonest pattern in these patients was normal cycling endometrium (42.32%). The commonest pathology irrespective of the age group was disordered proliferative pattern (26.15%). Other causes identified atrophic endometrium (11.5%), benign endometrial polyp (5.38%), endometrial hyperplasia (5.41%), carcinomas (0.79%) and chronic endometritis (1.54%).

Conclusions: The knowledge of endometrial pattern in a case of AUB helps to decide a plan of management. Endometrial sampling plays a very important role in management of AUB, especially in the age group of more than 40 years; i.e., the peri and post-menopausal age groups, where incidence of malignant or pre malignant conditions was noted to be the highest.


Abnormal uterine bleeding, Endometrial cancer, Endometrial sampling, Endometrial hyperplasia

Full Text:



Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. FIGO Working Group on Menstrual Disorders. Int J Gynaecol Obstet. 2011;113:3-13.

Fraser IS, Langham S, Uhl-Hochgraeber K. Health-related quality of life and economic burden of abnormal uterine bleeding. Expert Rev Obstet Gynecol. 2009;4:179-89.

Sharma A, Dogra Y. Trends of AUB in tertiary centre of Shimla hills. J Midlife Health. 2013;4:67-8.

Pillai SS. Sonographic and histopathological correlation and evaluation of endometrium in premenopausal women with abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2014;3:113-7.

Fraser IS, Critchley HO, Munro MG, Broder M. A process designed to lead to international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding. Writing Group for this Menstrual Agreement Process [published erratum appears in Fertil Steril. Fertil Steril 2007;87:466-76.

Mazur MT, Kurman RJ. Normal endometrium and infertility evaluation. In: Mazur MT, Kurman RJ, editors. Diagnosis of endometrial biopsies and curettings: A practical approach. 2nd ed. New York: Springer Verlag. 2005;7-33.

ACOG practice bulletin Diagnosis of abnormal uterine bleeding in reproductive aged women January 2012. Obstetrics and Gynecol. 2012;120(1):197-206.

RCOG Green top guideline no. 67, management of endometrial hyperplasia. 2016.

Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K et al. Incidence of endometrial hyperplasia. Am J Obstet Gynecol. 2009;200:678:1-6.

Simridhi B, Monika G, Tajinder K. Histopathological spectrum of endometrium in abnormal uterine bleeding. Intl J Reprod Contra Obstet Gynecol. 2018;7(9):3633-7.

Albers JR, Hull SK, Wesley RM. Abnormal uterine bleeding. Am Fam Phys. 2004;69:1915-26.

Bolde SA, Pudale SS, Pandit GA, Matkari PP. Histopathological study of endometrium in cases of abnormal uterine bleeding. Int J Res Med Sci. 2017;2(4):1378-81.

Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker VK. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynaecol India. 2011;61(4):426-30.

Perveen S, Perveen S. Endometrium histology in abnormal uterine bleeding. Med Channel. 2011;17(4):68-70.

Mutter GL. Diagnosis of premalignant endometrial disease. J Clin Pathol. 2002;55:326-31.

Cornitescu FI, T─ânase F, Simionescu C, Iliescu D. Clinical, histopathological and therapeutic considerations in non-neoplastic abnormal uterine bleeding in menopause transition. Rom J Morphol Embryol. 2011;52:759-65.

Baral R, Pudasini S. Histopathological pattern of endometrial samples in abnormal uterine bleeding. J Path Nepal 2011;1:13-6.

Kaliyath S, Shetty P, Jayaprakash S, Permi K, Panna H. Study of histopathological patterns of endometrium in abnormal uterine bleeding. Chrismed J health res. 2014;1:76-81.

Saroj A. Histopathological study of endometrium in cases of abnormal uterine bleeding. Int J Res Med Sci. 2017;2(4):1378-81.

Chauhan S, Radhakrishnan K. Clinical profile of endometrial histopathological patterns in Abnormal Uterine Bleeding. Nepal J Obstetr Gynaecol. 2020;15(1):50-4.