Study of endometrial histopathology in women with abnormal uterine bleeding

Authors

  • Ushadevi Gopalan Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Kancheepuram District, Tamilnadu, India
  • Sathiyakala Rajendiran Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Kancheepuram District, Tamilnadu, India
  • Karnaboopathy Ranganathan Department of Obstetrics and Gynecology, Shri Sathya Sai Medical College and Research Institute, Ammapettai village, Kancheepuram District, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170442

Keywords:

Fetal distress, Hypertension in pregnancy, Stillbirths

Abstract

Background: Abnormal uterine bleeding is a major gynaecological problem accounting for 33% of Gynaec outpatients. The cause of the bleeding is established in only 50-60% of the cases. The aim of this study was to evaluate the various histopathological patterns in the endometrial biopsy of patients presenting with abnormal uterine bleeding and to determine the specific pathology in the different age groups.

Methods: This was a prospective study done in a tertiary care teaching hospital for a period of 2 years. Total of 905 patients with abnormal uterine bleeding were included in the study and they were subjected to a Dilatation and Curettage. Histopathological examination of the endometrial biopsy was done and the various histopathological patterns identified and classified.

Results: The age of patients ranged from 24-74 years. 54.7% were in the age group 40-49 years followed by 23.4% in the age group 30-39 years. The most frequent findings were proliferative findings in 47.3% followed by secretory endometrium in 16.1 % patients. Proliferative endometrium was more common in the age group 40-49 years as also disordered proliferation, secretory endometrium, cystoglandular hyperplasia and endometrial hyperplasia.

Conclusions: Endometrial curettings and biopsy is an important diagnostic procedure for assessing all cases of abnormal uterine bleeding and to plan for successful management.

References

Munro MG. Abnormal uterine bleeding in the reproductive years: Pathogenesis and clinical investigations. J Am Assoc Gynecol laparos. 1999;6:393-416.

Mencoglia L, Perino A, Hamou J. Hysteroscopy in perimenopausal and post-menopausal women with abnormal uterine bleeding. J Reprod Med. 1987;32:577-82.

Khrouf M, Terras K. Diagnosis and management of formerly called dysfunctional uterine bleeding according to PALM-COEIN FIGO classification and the new guidelines. J Obstet Gynecol India. 2014;64(6):388-93.

Kotdawala P, Kotdawala S, Nagar N. Evaluation of endometrium in peri-menopausal abnormal uterine bleeding. J Midlife health. 2013;4(1):16-21.

Fraser IS, Sungurtekin U. Defining menstrual disturbances. In Maclean A and O’Brien, P.M.S.(eds) Study Group on Menstrual Disorders. Royal College of Obstetricians and Gynecologist. 2000;141-52.

Khan R, Sherwani R, Rana S, Hakim S, Jairajpuri ZS. Clinico-Pathological Patterns in Women with Dysfunctional Uterine Bleeding. Iran J Pathol. 2016;11(1):20-6.

Muzaffar M, Akhtar KAK, Yasmin S, Rahman M, Iqbal W, Khan MA. Menstrual irregularities with excessive blood loss: A Clinico-Pathological Correlation. J Pak Med Assoc. 2005;55:486-9.

Brand A, Dubuc-Lissoir J, Ehlen TG, Plante M. Diagnosis of endometrial cancer in women with abnormal vaginal bleeding. J Soc Obstet Gynecol Can. 2000;22:102-4.

Stovall TG, Ling FW, Morgan PL. A prospective randomized comparison of the Pipelle endometrial sampling device with the Novak curette. Am J Obstet Gynecol. 1991;165(5,1):1287-90.

Goldstein SR, Zeltser L, Horan CK, Snyder JR, Schwatrz LB. Ultrasound based triage for perimenopausal women with abnormal uterine bleeding. Am J Obstet Gynecol. 1997;177:102-8.

Clark TJ, Mann CH, Shah N, Khan KS, Song F, Gupta JK. Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: A Systematic Quantitative review. BJOG. 2002;109:313-21.

Dijkhuizen FP, Mol BW, Brolman HA, Heintz AP. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000;8:1765-72.

Rosai J. Female reproductive system-uterus-corpus. In: Rosai and Ackerman’s surgical pathology. 9th edition; Mosby: an imprint of Elsevier, Missouri, 2005;1579-615.

Dangal G. A study of endometrium of patients with abnormal uterine bleeding at Chitwan valley. Kathmandu University. Med J. 2003;1:110-2.

Todorovic N, Djordjevic V, Antonijevic S. Results of histopathological findings of endometrial changes in metrorrhagia. Srp Arh Celok Lek. 2002;130:386-8.

Yusuf NW, Nadeem R, Yusuf AW, Rahman R. Dysfunctional Uterine Bleeding. A retrospective clinicopathological study over 2 years. Pak J Obstet Gynecol.1996;9:27-30.

Doraiswami S, Johnson T, Rao S, Rajkumar A, Vijayaraghavan J, Panicker V. Study of endometrial pathology in Abnormal Uterine bleeding. J Obstet Gynecol India. 2011;61(4):426-30.

Damle RP, Dravid NV, Suryawanshi KH, Gadre AS, Bagale P S, Ahire N. Clinicopathological spectrum of endometrial changes in peri-menopausal and post-menopausal Abnormal Utrine Bleeding: a 2 year study. J Clin Diagn Res. 2013;7(12):2774-6.

Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. J Pathol Nepal. 2012;2:297-300.

Khare A, Bansal R, Sharma S, Elhence P, Makkar N, Tyagi Y. Morphological spectrum of Endometrium in patients presenting with Dysfunctional Uterine Bleeding. People’s Journal of Scientific Research. 2012;5(2):13-6.

Khan S, Hameed S, Umber A. Histopathological pattern of Endometrium on Diagnostic D and C in patients with Abnormal Uterine Bleeding. Annals. 2011;17(2):166-70.

Sheetal GP, Bhute SB, Inamdar SA, Acharya NS, Shrivastava DS. Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation. J Endosc Surg. 2009;1(2):98-104.

Fakhar S, Saeed G, Khan AH, Alam AY. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding. Ann Saudi Med. 2008;28(3):188-91.

Bhosle A, Fonseca M. Evaluation and Histopathological correlation of Abnormal Uterine Bleeding in Perimenopausal women. Bombay Hospital Journal. 2010;52(1):69-72.

Jetley S, Rana S, Jairajpuri ZS. Morphological spectrum of endometrial pathology in middle-aged women with atypical uterine bleeding: A study of 219 cases. J Midlife Health. 2013;4(4):216-20.

Chary N, Fathima A, Rani J. Endometrial histopathological changes associated with Dysfunctional Uterine Bleeding. Asian Pac J Health Sci. 2016;3(2):106-9.

Abdulla LS, Bondagji NS. Histopathological pattern of Endometrial Sampling performed for Abnormal Uterine Bleeding. Bahrain Medical Bulletin. 2011;33(4):1-6.

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

Michail G, Karahaliou A, Skiadopoulos S, Kalogeropoulou C, Terzis G, Boniatis I et al. Texture analysis of perimenopausal and post-menopausal endometrial tissue in gray scale transvaginal ultrasonography. Br J Radiol. 2007;80:609-16.

Moghal N. Diagnostic value of endometrial curettage in abnormal uterine bleeding- a histopathological study. J Pak Med Assoc. 1997;47:295-9.

Valle RF. Hysteroscopic evaluation of patients with abnormal uterine bleeding. Surg Gynecol Obst. 1981;153:521-6.

Jyotsana, Manhas K, Sharma S. Role of hysteroscopy and laparoscopy in evaluation of abnormal uterine bleeding. JK Sci. 2004;6:1.

Jong PD, Doel F, Falconer A. Outpatient diagnostic hysteroscopy. Br J Obstet Gynecol. 1990;97:2.

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

Munro MG. Abnormal uterine bleeding in the reproductive years. J Am Assoc Gynecol laparos. 1999;6(4):391-419.

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Published

2017-02-19

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Original Research Articles