Clinicopathological evaluation of abnormal uterine bleeding in perimenopausal women


  • Lithingo Lotha Department of Obstetrics and Gynaecology, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Asha Borah Department of Obstetrics and Gynaecology, Assam Medical College and Hospital, Dibrugarh, Assam, India



Abnormal uterine bleeding, Histopathology, Perimenopause


Background: Abnormal uterine bleeding is considered as one of the most common and challenging problem presenting to the gynecologist. It is responsible for as many as one third of all outpatient gynaecological visits. This study was carried out in the department of Obstetrics and Gynaecology, Assam Medical College and Hospital, Dibrugarh to evaluate clinically gynaecological causes and the endometrial pattern of abnormal uterine bleeding in perimenopausal women.

Methods: This is a retrospective study of 148 perimenopausal women with complain of abnormal uterine bleeding in the age group ranging from 40-50 years for a period of one year from 01 November 2014 to 30 November 2015. The age, parity, menstrual complaints were noted and clinical diagnosis with ultrasound report and histopathological reports (of endometrial tissue) were analyzed. Finally the histopathological report of the hysterectomy specimen was correlated.

Results: Menorrhagia was the commonest complaint. AUB was seen more in multiparous women (64.8%). Fibroid uterus was the commonest cause which is 52.7% followed by DUB 41.2%, adenomyosis 4.7%, and uterine malignancy 1.3%.

Conclusions: Clinicopathological evaluation of AUB showed that fibroid uterus followed by DUB is the most common cause in perimenopausal women. Occurrences of endometrial hyperplasia increases in perimenopause which is of great value as it is a forerunner of carcinoma.


Spencer CP. Whitehead MI. Endometrial assessment revisited. B J obset gynecol. 1999;106:623-32.

Chabra S, Jaswal M, Nangia V. Uterine size, endometrium, fertility in women with dysfunctional uterine bleeding. J obstet gynaecol India. 1992;42:623-32.

Davey DA. Dysfunctional uterine bleeding. In Whitfield CR editor; Dewhursts Textbook of Obstetrics and Gynaecology for postgraduates. Glasgow, Blackwell Science. 1997:590-608.

Mehrotra VG, Mukherjee K, Pandey M, Samanth V. Abnormal uterine bleeding (a review of 150 cases). J of Obstet Gynecol India. 1972;22:684-9.

Pilli GS, Seth SB. Dysfunctional uterine bleeding-a study of 100 cases. J Obstet Gynecol of India. 2002;52(3):87-9.

Zarawar MP, Bolde S. Histopathological study of endometrium in dysfunctional uterine bleeding. Solapur Med J. 2005;1(4).

Archana B, Michelle F. Evaluation and histopahological correlation of abnormal uterine bleeding in perimenopausal women. J Bombay Hosp. 2010;52:69-72.

Hafiz R, Ali M, Ahmad M. Fibroid as a causative factor in menorrhagia and its management. Pakistan J Med Res. 2003;42;3.

Ghani NA, Abdulrajak AA, Abdullah EM. Abnormal uterine bleeding: a histopathological study. World Research Journal of Clinical Pathology. 2012;1(1): 6-8.

Debdas AK, Bahol A. Histological profile of diagnostic endometrial curettage and its significance. J of the Indian Med Assoc. 1984;82:309-12.

Mahmood MF. Irregular uterine bleeding over the age of 40 years. Ind J Obstet Gynecol. 1988;2(1):2-6.

Sarawat A, Roohi M. Histological diagnosis by conventional dilatation and curettage. Professional Med J. 2011;18(4):587-91.

Arti R, Nayan A. Abnormal uterine bleeding-a clinicopathological study of 160 cases. Asian J Med Res. 2013;2(1):15-8.

Smita S. Validation of endometrial curettage in abnormal uterine bleeding in a teaching institute of Central India: a prospective study. Int J Med Res Health Sci. 2013;2(3):491-5.

Saraswati D, Thanka J. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynecol of India. 2011;61(4):426-30.

Zeeba S. Atypical uterine bleeding-histopathological audit of endometrium. A study of 638 cases. Al amen j Med Sci. 2013;6(1):21-8.






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