Clinicopathological analysis of AUB in perimenopausal and postmenopausal women in cancer care centre: special reference to carcinoma endometrium
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20212660Keywords:
AUB, Cancer endometrium, Histopathology of endometriumAbstract
Background: Abnormal uterine bleeding (AUB) may be defined as any variation from normal menstrual cycle including alteration in its regularity, frequency, duration of flow and amount of blood loss. Postmenopausal bleeding is a danger sign for malignancy. The study aimed to study the histopathology spectrum of hysterectomy specimens and bleeding patterns in perimenopausal women and postmenopausal women.
Methods: It was a retrospective observational study done at Government Medical College and Cancer Hospital, Aurangabad (MS) from January 2017 to January 2021. Total sample size was 100 women. Perimenopausal and postmenopausal women undergoing hysterectomy were analysed for the age, parity, etieology, histology and the malignant changes.
Results: 22 cases of AUB were observed in the age group of less than 40 years. 56% cases presented with heavy menstrual bleeding 58% cases had prolonged menstrual bleeding. 36% cases had endometrial cause (harmonal disturbances), 12 % had endometrial polyp and 35 cases out of 100 had endometrial carcinoma. Both type 1 and type 2 cases of carcinoma endometrium are seen in this study.
Conclusions: Excessive uterine bleeding is a common gynaecological problem in all age groups with significant patient morbidity. The spectrum of endometrial lesions seen in AUB and cancer cases shows that the histopathological examination of endometrium is gold standard diagnostic tool in evaluation of AUB and postmenopausal bleeding and there is an age specific association of endometrial lesions.
References
Fraser IS, Critchley HO, Munro MG, Broder M. Can we achieve international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod. 2007;22(3):635-43.
Talukdar B, Mahela S. Abnormal uterine bleeding in perimenopausal women: correlation with sonographic findings and histopathological examination of hysterectomy specimens. J Midlife Health. 2016;7(2):73-7.
Singh S, Best C, Dunn S, Leyland N, Wolfman WL, Wolfman W, et al. Abnormal uterine bleeding in premenopausal women. J Obstetr Gynaecol Canada. 2013;35(5):473-5.
Puvitha RD, Shruthi EMS, Shylaja S. Histopathological study of endometrium in abnormal uterine bleeding an experience in a tertiary care centre of Rural South India. National J Basic Med Sci. 2017;8(1):32-8.
Deka RR, Saikia T, Handique A, Sonowal B. Histopathological spectrum of endometrial changes in women presenting with abnormal uterine bleeding with special reference to endometrial malignancies:a two years hospital based study. Annals Applied Biosci. 2016;3(2):44-9.
Cheong Y, Cameron IT, Critchley HOD. Abnormal uterine bleeding. Br Med Bull. 2017;123(1):103-14.
Bolde SA, Pudale SS, Pandit GA, Matkari PP. Histopathological study of endometrium in cases of abnormal uterine bleeding. Int J Res Med Sci. 2017;26:2(4):1378-81.
Clark TJ, Stevenson H. Endometrial polyps and abnormal uterine bleeding (AUB-P): what is the relationship, how are they diagnosed and how are they treated? Best Pract Res Clin Obstet Gynaecol. 2017;40:89-104.
Bittencourt CA, Simões DSR, Bernardo WM. Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;50:32-9.
Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO working Group on menstrual disorder. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in non-gravid women of reproductive age. Int J Gynaecol Obstet. 2011;113:3-13.
Hauk L. American College of Obstetricians and Gynecologists. ACOG releases guidelines on management of abnormal uterine bleeding associated with ovulatory dysfunction. Am Fam Physician. 2014;89:987-8.
Zaino RJ, Kurman R, Herbold D. The significance of squamous differentiation in endometrial carcinoma: data from a Gynecologic Oncology Group study. Cancer. 1991;68(10):2293-302.
Güzel AI, Akselim B, Erkılınç S. Risk factors for adenomyosis, leiomyoma and concurrent adenomyosis and leiomyoma. J Obstet Gynaecol Res. 2015;41:932-7.
Taran FA, Weaver AL, Coddington CC. Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study. Hum Reprod. 2010;25:1177-82.
Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. J pathol Nepal. 2012;2(4):297-300.
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.
Colgan TJ, McLachlin CM. In Comprehensive Cytopathology. Available at 2008 https: //www.sciencedirect.com/science/article/pii/B9781416042082100107. Accessed on 12 January 2021.
Burke WM, Orr J, Leitao M, Salom E, Gehrig P, Olawaiye AB, et al. Endometrial cancer: a review and current management strategies: part I. Gynecologic Oncology. 2009;134(2):385-92.
Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham FG. Endometrial Cancer. Williams Gynecology (2nd edition). McGraw-Hill. 2012:833.
