Correlation of clinical features, thyroid status and endometrial histopathology in abnormal uterine bleeding
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260889Keywords:
Abnormal uterine bleeding, Clinicopathological correlation, Endometrial thickness, Thyroid statusAbstract
Background: Abnormal uterine bleeding (AUB) is considered as one of the most common but yet a challenging problem presenting to the gynaecologist. AUB is defined as abnormal changes occurring in the frequency of menstruation, duration of flow or amount of blood loss. Its impact on women's physical, social, emotional and maternal quality of life is substantial. A detailed clinical assessment, thyroid profile, measurement of endometrial thickness on sonography and histopathological evaluation of endometrium is crucial for diagnosing the underlying causes of AUB.
Methods: A cross-sectional study was conducted over 18 months at a tertiary healthcare centre. This study enrolled 245 patients aged over 35 years presenting with complaints of AUB. Clinical data of all patients were collected via structured interviews and examinations. They were subjected to thyroid function test and ultrasonography for endometrial thickness. Endometrial samples were obtained through dilatation and curettage (D and C) and analysed histopathologically. The clinical presentation was correlated with histopathological findings of the endometrium.
Results: The majority of patients were in the age group 41-45 years (31.8%), with a mean age of 44.8 years. Menorrhagia was found to be the most common bleeding pattern (57.1%), followed by menometrorrhagia (30.2%) and postmenopausal bleeding (12.7%). Endometrial hyperplasia without atypia was the predominant histopathological finding (63.3%), followed by proliferative phase (17.1%) and secretory phase (14.3%). Endometrial carcinoma was identified in 3.7% of cases.
Conclusions: Histopathological examination is the gold standard investigation for patients presenting with AUB. Clinicopathological correlation aids in accurate diagnosis, early detection of premalignant lesions and appropriate management, thereby improving patient outcomes.
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References
Doddamani UG, Doddamani GB, Katageri G, Mallapur A. Clinicopathological Correlation of Endometrium in Abnormal Uterine Bleeding. Scholars J Appl Med Sci (SJAMS). 2014;2(1):46-9.
Chapagain S, Dangal G. Clinical and Histopathological Presentation of Abnormal Uterine Bleeding in Perimenopausal Women in a Tertiary Center of Nepal. J Nepal Health Res Counc. 2020; 18(2):248-52. DOI: https://doi.org/10.33314/jnhrc.v18i2.2512
Kathleen G, Patil MS, Anand AS. Histopathological correlation of endometrial samples in pre and postmenopausal women with abnormal uterine bleeding. J Diagn Pathol Oncol. 2019;4(1):32-8. DOI: https://doi.org/10.18231/2581-3706.2019.0006
Jagdale NG, Gawandi P, Tirankar V. A study of histopathological correlation of abnormal uterine bleeding with clinical symptoms. Medpulse Int J Gynaecology. 2020;16(2):17-22. DOI: https://doi.org/10.26611/10121621
Sahu HD, Varma AV, Karmarkar S, Malukani K, Khanuja A, Kesharwani P. Endometrial Histopathology in Abnormal Uterine Bleeding and Its Relation with Thyroid Profile and Endometrial Thickness. Cureus. 2023;15(4):e37931. DOI: https://doi.org/10.7759/cureus.37931
Thapa S, Acharya I. Endometrial Histopathology in Abnormal Uterine Bleeding: A Retrospective Analysis. Med J Shree Birendra Hosp. 2021;20(1):1-5. DOI: https://doi.org/10.3126/mjsbh.v20i1.32649
Nair R, Mallikarjuna M. Clinical profile of patients with abnormal uterine bleeding at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2015;4(6):1753-7. DOI: https://doi.org/10.18203/2320-1770.ijrcog20151224
Mune SB, Karche AG, Histopathological patterns of endometrial lesions in patients with abnormal uterine bleeding in rural area of Western Maharashtra. Indian J Pathol Oncol. 2016;3(4):665-72. DOI: https://doi.org/10.5958/2394-6792.2016.00124.1
Sinha K, Gurung P, Sinha HH, Bhadani PP. Study on abnormal uterine bleeding among adult women in a tertiary care hospital in Bihar, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(8):3136-40. DOI: https://doi.org/10.18203/2320-1770.ijrcog20183305
Golecha N, Porwal V. Abnormal uterine bleeding: A study of its clinical spectrum and incidence of histopathological patterns of endometrium as a function of age with parity. Indian J Obstet Gynecol Res. 2018;5(3):339-43. DOI: https://doi.org/10.18231/2394-2754.2018.0078
Kumar KTAK, Upadhyaa K. A clinicopathological study of the endometrium-deciphering patterns of abnormal uterine bleeding. Int J Curr Pharm Res.2025;17(2):75-8. DOI: https://doi.org/10.22159/ijcpr.2025v17i2.6079
Nikethan B, Preethi C.R, Anusha BM, Gowda VV. A study of histomorphological patterns of endometrium in abnormal uterine bleeding. IP Arch Cytol Histopathol Res. 2020;5(1):26-30. DOI: https://doi.org/10.18231/j.achr.2020.007
Pidigundla D, Junutula B, Sivasankara Naik V, Diagnostic value of endometrial samples in women with abnormal uterine bleeding at a tertiary care centre. Indian J Pathol Oncol. 2023;10(4):366-70. DOI: https://doi.org/10.18231/j.ijpo.2023.082
Pundir V, Rawat V, Negi S. Clinicoradiological and histopathological study of endometrial lesions in abnormal uterine bleeding. J Med Sci Health. 2024;11(4):101-7.
Koirala S, Pande K, Shrestha S. Correlation of Abnormal Uterine Bleeding (AUB) with Thyroid Profile and Endometrial Biopsy. Nepal Med Coll J. 2021;23:334-9. DOI: https://doi.org/10.3126/nmcj.v23i4.42227
Malik R, Singh D. Clinicopathological Correlation of Abnormal Uterine Bleeding Patterns with Endometrial Histopathology. Int J Med Sci Public Health Res. 2025;6(6):1-6.
Banmeru AP, MN. From symptoms to surgery: clinicopathological correlation in women undergoing hysterectomy for abnormal uterine bleeding. Int J Reprod Contracept Obstet Gynecol. 2025;14(2): 555-60. DOI: https://doi.org/10.18203/2320-1770.ijrcog20250193